磁共振静脉成像对Budd-Chiari综合征侧枝循环的诊断价值

目的探讨磁共振静脉成像(MRV)诊断Budd-Chiari综合征(BCS)侧支循环的价值。方法回顾性分析25例BCS患者的MRV图像,观察肝静脉、下腔静脉病变及侧支循环交通情况。结果 25例BCS患者的侧支循环被分为肝内侧支、肝外侧支两大类。肝内侧支:肝静脉—副肝静脉引流型18例;肝内静脉间交通8例;肝静脉经包膜下侧支与体循环交通20例;肝静脉与门静脉交通1例。肝外侧支:腰升静脉-奇静脉及半奇静脉侧枝25例;左肾静脉属支通道15例;肾周静脉交通25例;腹壁浅静脉通道25例;食管胃底静脉曲张—奇静脉—上腔静脉通道15例。结论 MRV能够较好地评价BCS患者的侧支循环情况,对指导BCS介入治疗有重要临床价值。

The diagnositic value of collateral circulation in Budd-Chiari syndrome with magnetic resonance venography

Objective To explore the diagnositic value of collateral circulation in Budd-Chiari syndrome （BCS） with magnetic resonance venography（MRV）. Methods The 25 cases of BCS were retrospectively analysed by MRV. The hepatic vein and inferior vena cava lesions and collateral circulation traffic conditions observed. Results The collateral circulation imaging of 25 patients was divided into two collaterals. Intrahepatic collaterals were further classified categories, which be classified as intrahepatic and extrahepatic as the following four types：①18 cases of Hepatic vein（HV）vice hepatic venous drainage type; ②8 cases of the traffic between the HV; ③20 cases of tmder the subcapsular collateral and systemic traffic ）. ④ 1 cases of the HV and portal vein traffic. Extrahepatic collaterals include：①25 cases of ascending lumbar vein and azyos/hemiazygos venous collateral circulation;②15cases of left renal vein branch channel; ③25 cases of Renal vein traffic around; ④25 cases of superficial epigastric vein channel; ⑤15 cases of Esophageal and gastric varices-azygos vein-superior vena cava channel. Conclusion MRV can be better evaluated collateral circulation in patients with BCS. It is important for the interventional treatment of BCS.