Budd-Chiari综合征:肝静脉病变的多排螺旋CT诊断

目的探讨多排螺旋CT(MSCT)对Budd-Chiari综合征(BCS)肝静脉阻塞病变的诊断价值。方法对比分析26例BCS的肝静脉血管造影和术前1周内的MSCT平扫与增强扫描表现。结果26例MSCT横断面图像和重建图像显示肝静脉共计70条,其中56条肝静脉闭塞,包括13条肝右静脉闭塞,21条肝中静脉闭塞,22条肝左静脉闭塞;另显示21条副肝静脉代偿性增粗;其中1例肝右静脉伴有血栓形成。与下腔静脉或经皮肝穿刺肝静脉造影相比,肝静脉的符合率为92.11%。结论MSCT能准确显示BCS肝静脉的血流动力学变化、阻塞部位,性质以及肝内交通支情况,诊断价值高,能可靠的指导制订治疗方案。

Budd-Chiari Syndrome: Multi-detector Spiral CT Diagnosis for Hepatic Vein Lesion

Objective To study the value of multi-detector spiral CT(MSCT) dynamic enhancement in diagnosis of Budd-Chiari syndrome with occlusion of hepatic vein(HVBCS).Methods 26 patients with HVBCS confirmed by digital subtraction angiography were retrospectively analyzed.All patients received MSCT dynamic enhanced scans within one weeks before aperation.Results In twenty-six patients,a total of 56 hepatic veins were occluded,including 13 right hepatic veins,21 middle hepatic veins,22 left hepatic veins,and a right hepatic vein with thromboses.At the same time,a total of 21 accessory hepatic veins were dilated.In comparison with the findings of hepatic vein angiography,the accuracy rate of MSCT for hepatic veins and accessory hepatic veins was 92.11%.Conclusion MSCT dynamic enhanced scans can accurately reflect the changes of intrahepatic hemodynamics,the location of hepatic veins occlusion and intahepatic collateral circulation in BCS,and have significant value in diagnosis and therapy of the Budd-Chiari syndrome.