彩色多普勒超声在布-加综合征诊断及分型中的价值

目的:探讨彩色多普勒超声在布-加综合征(BCS)诊断及分型中的应用价值。方法:51例经下腔静脉造影或手术证实的BCS患者,分析其彩色多普勒超声直接和间接征象,并根据肝段下腔静脉和(或)肝静脉的阻塞情况进行分型。结果:51例BCS中,下腔静脉型22例,肝静脉型9例,混合型16例,漏诊4例,超声诊断符合率92.2%(47/51),超声分型与血管造影或手术诊断一致。直接征象表现为肝静脉和(或)下腔静脉隔膜或纤维性狭窄、闭塞或栓塞;而肝尾叶增大、肝内交通支和下腔静脉侧支是重要的间接征象。超声漏诊4例均为下腔静脉型,与诊断意识不足和超声成像的局限性有关。结论:彩色多普勒超声有助于明确布-加综合征诊断和分型,可作为临床首选的检查方法。

The value of color doppler ultrasonography in classification and diagnosis of Budd-Chiair syndrome

Objective:To assess the value of color Doppler ultrasonography in classification and diagnosis of Budd-Chiair Syndrome(BCS).Methods: The direct and indirect symptoms of color Doppler ultrasonography in 51 patients with BCS were analyzed.And all of them were classified based on the blockage of inferior vena cava and hepatic vein.All cases were confirmed by inferior vena cava angiogram or surgery.Results: The inferior vena cava and(or) hepatic vein were found membranous or fibrous stenosis even occlusion or embolism,in which inferior vena cava was found in 22cases,hepatic vein in 9 cases and both of them are found in 16 cases.4 cases were failed to diagnose.In this group the accuracy of color Doppler ultrasonography was 92.2%(47/51).This was corresponded to inferior vena cava angiogram or surgery.Caudate lobe hypertrophy and collateral circulations were all important indirect signs.The 4 misdiagnosed cases were all obstructed in inferior vena cava,which were related to the insufficient awareness of diagnosis and limitations of ultrasonic imaging.Conclusion: Color Doppler ultrasonography can diagnose and classify different types of BCS exactly,which should be the initial diagnosis procedure for Budd-Chiari syndrome.