布加综合征的多层螺旋CT诊断

Multislice CT diagnosis of Budd-Chiari syndrome

目的探讨多层螺旋CT(multislice spiral CT,MSCT)在布加综合征(Budd-Chiari syndrome,BCS)中的诊断价值。方法回顾性分析28例经DSA或手术证实的布加综合征MSCT影像特点。结果BCS的MSCT特点为:①CT平扫形态学改变:肝脏不规则增大15例,弥漫增大10例,未见明显改变3例;②强化特征:花斑状强化型11例,周边强化型6例,中央强化型8例,不规则强化3例;③CTA准确显示阻塞的部位及侧支循环血管:肝静脉闭塞3例;下腔静脉狭窄闭塞25例,其中7例伴肝静脉闭塞;显示肝外侧支循环16例,肝内侧支循环2例,肝内外均有侧支循环7例,3例无侧支循环血管。结论MSCT能准确直观反映布加综合征阻塞的性质、部位、范围、侧支血管及其与周围器官的空间关系,能从形态及功能上反映肝脏损害程度。

Objective To evaluate the multislice CT （MSCT） in the diagnosis of Budd-Chiari syndrome （BCS）. Methods CT features of 28 cases with Budd-Chiari syndrome confirmed by DSA or operation were retrospectively analyzed. Results MSCT features of BCS： （1）The morphologic changes on CT plain scan： enlargement of caudate lobe of the liver （ 15 cases）, diffuse enlargement of the liver （ 10 cases）, no significant changes （3 cases）. （2）Enhanced features ： mottled （ 11 cases）, peripheral （6 cases）, central （8 cases）, irregular （3 cases）. （3）CTA accurately showed the location and obstruction of collateral vascular circulation： hepatic vein （HV） occlusion （3 cases）, inferior vena cava （IVC） narrow occlusion （25 cases）, and HV occlusion （7 cases）. CTA also showed collateral circulation outside the liver （16 cases）, inside the liver （2 cases） , both inside and outside the liver （7 cases） , and no collateral circulation （3 cases）. Conclusion Multislice CT can accurately and directly reflect the nature, position, scope, collateral circulation and space rela- tion, as well as the morphological and functional damage of liver. Multislice CT is a reliable method to diagnose BCS and is useful in the treatment of BCS.