MRI LAVA扫描技术评估布-加综合征患者侧支循环研究*

目的 分析采用磁共振成像(MRI)肝脏加速容积采集(LAVA)扫描技术评估布-加综合征(BCS)患者侧支循环的效果。方法 2017年3月～2022年3月我院收治的BCS患者47例,均接受数字减影血管造影(DSA)和MRI检查。以DSA检查结果为“金标准”,判断MRI LAVA对BCS分型诊断的准确率。结果 DSA检查诊断肝静脉阻塞型BCS 18例,下腔静脉阻塞型BCS 21例和混合型BCS 8例,而MRI LAVA诊断肝静脉阻塞型16例,下腔静脉阻塞型21例,混合型10例,其准确性为95.7%;在47例BCS患者中,MRI LAVA显示膈下静脉扩张9例(19.1%),肝内交通支扩张12例(25.5%),腹壁浅静脉扩张26例(55.3%),副肝静脉扩张26例(55.3%),奇/半奇静脉扩张39例(83.0%);与DSA检查比,MRI LAVA显示副肝静脉的准确性为100%。结论 采用MRI LAVA扫描技术能够准确判断BCS分型,观察不同类型侧支循环建立情况,为临床诊疗提供依据。

MRI LAVA scanning for collateral circulation in patients with Budd-Chiari syndrome

Objective The aim of this study was to analyze the magnetic resonance imaging (MRI) with accelerated volume acquisition (LAVA) technology in evaluating collateral circulation in patients with Budd-Chiari syndrome (BCS). Methods 47 patients with BCS were admitted to our hospital between March 2017 and March 2022, and all underwent digital subtraction angiography (DSA) and MRI scan. The DSA results acted as the "gold standard" to determine the accuracy(Ac) of MRI LAVA on BCS typing and the collateral circulation. Results Among the 47 patients with BCS, the DSA showed hepatic vein occlusion in 18 cases, inferior vena cava occlusion in 21 cases, and mixed type in 8 cases, and the MRI LAVA found hepaticvein occlusion in 16 cases, inferior vena cava occlusion in 21 cases, and mixed occlusion in 10 cases,with the Ac of 95.7%; the MRI LAVA also showed inferior phrenic vein dilatation in 9 cases(19.1%), the intrahepatic communicating branch in 12 cases (25.5%), the superficial abdominal vein dilatation in 26 cases(55.3%), the accessory hepatic vein in 26 cases(55.3%), the azygos/hemiazygos vein in 39 cases(83.0%); the Ac in demonstrating accessory hepatic vein by MRI LAVA was 100%, as compared to by DSA. Conclusion The MRI LAVA scanning could accurately determine the classification of BCS and the collateral circulation establishment, which might   guide the clinicians for appropriate management.