彩色多普勒超声对布—加氏综合征和门脉性肝硬化的鉴别诊断探讨

目的 探讨彩色多普勒(CDFI)对布-加氏综合症(Budd-Chiari Syndrome)和门脉性肝硬化的鉴别诊断。方法 分别对48例布-加氏综合征(简称第一组)与56例门脉性肝硬化(简称第二组)患者的肝静脉、下腔静脉和门脉系统的血流动力学和肝脾声像图进行检测。结果 第一组:A:肝静脉近端变细,占63.8％(92/144),伴侧枝血管形成,其中7支管腔内有膜状物;B:下腔静脉上段变细占66.6％(32/48);C:门脉血流无异常改变;D:肝测值增大,无结节感;脾正常或轻度增大。第二组:A:肝静脉普遍变细,分支减少,占100％(168/168);B:门脉系统测值增粗,占100％(56/56);C:下腔静脉血流正常;D:肝缩小伴弥漫结节,脾脏肿大。结论 CDFI是布-加氏综合征和门脉性肝硬化诊断与鉴别诊断的首选方法。

Discussion on Differential Diagnosis of Budd-Chiari Syndrome and Portal Cirrhosis with CDFI

Objective To discuss the differential diagnosis of Budd-chiari syndrome and portal cirrhosis with CD-FI. Methods The hemodynamics of hepatic veins, inferior vena cava and portal system, and the images of liver andspleen, 48 cases of Budd-chiari syndrome in Group One while 56 cases of portal cirrhosis in Group Two, were stud-ied. Results Group One: (A)63.8% of all the cases(92/144)showed a thinner proximal end of hepatic veins withthe formation of collateral branch blood vessels, membranoid substance was formed in 7 lumens. (B) 66.6% cases(32/48)showed a thinner upper end of inferior vena cava. (C)No abnormal changes occurred in portal blood flow.(D)Liver was detected enlarged, without nodes; normal spleen or enlarged slightly. Group Two: (A)Hepatic veinswere generally getting thinner and branches decreased, which occurred in all the cases (100%, 168/168). (B)Portalsystem was detected thicker in all the cases (100%, 56/56). (C)The blood flow was normal in inferior vena cava.(D)Liver became smaller with diffuse nodes; spleen swelling. Conclusion CDFI is the first choice in diagnosis anddifferential diagnosis for the patients with Budd-chiari Syndrome and portal cirrhosis.