Budd-Chiari综合征的影像综合诊断与介入治疗

根据近10年来国内文献报告，Budd-Chiari综合征在我国黄河和淮河中下游区域已经成为一种比较常见的疾病，其发病率在苏、鲁、豫、皖交界地区高达10/10万。超声、CT、MRI和血管造造影的综合应用使Budd-Chiari综合征的检出率显著提高。尾状叶增大，肝静脉之间交通支形成，肝静脉或下腔静脉结构消失，下腔静脉钙化，肝脏增强扫描不均匀强化等已经成为Budd-Chiari综合征特有的的影像学表现和征象。尽管Budd-Chiari综合征的病因和发病机制至今仍未明确，但是，Budd-Chiari综合征的介入治疗在我国已经取得突破性进展。使用球囊扩张和血管内支架植入能够使阻塞的肝静脉或（和）下腔静脉再通，多种介入技术的联合应用使Budd-Chiari综合征的介入治疗的禁忌证逐渐缩小，采用多途径穿刺可以明显提高介入治疗成功率。介入治疗Budd-Chiari综合征的成功率可以达到96%，介入治疗术中病死率低于1/425，再狭窄发生率为20%。介入治疗已经成为Budd-Chiari综合征首选的治疗方法。

Synthetic Imaging Diagnosis and Interventional Therapy of Budd-Chiari Syndrome

Budd - Chiari syndrome(BCS) has turned into a common disease in middle and lower reaches of Yellow River and Huai River based on Chinese literature in later 10 years. The incidence of BCS was 10/ 100,000 in the interface among provinces Jiangsu,Shandong,Henan and Anhui.Higher rate of discover of BCS is attributed to use of Ultrasound, CT, MRI and DSA. It is a characteristic sign in imaging diagnosis of BCS that includes enlargement of caudal lobe, collateral circulation between hepatic veins, disappearance of the profile of hepatic veins or/ and inferior vena cava, calcification of IVC, different enhancement of hepatic parenchyma in CT enhancing scan.Although it is now unclear of etiology and pathogenesis of BCS,it get on with interventional therapy of BCS greatly in china. The recanalization of hepatic vein and IVC obstruction has been realized with PTA and stenting. The contraindication of interventional therapy in BCS has being reduced because of using multiple interventional techniques together. It can get the high successful rate of PTA that uses puncture of multiple ways. The successful rate was 96% in interventional therapy of BCS in our patients.The mortality was 1/ 425 in process of PTA.The rate of the restenosis after PTA and stenting was 20% in our patients.PTA and stenting has become the first selective method in treatment of BCS.