增强CT横轴位在布-加综合征诊断中的作用

The effect of contrast-enhanced CT axial images for the diagnosis of Budd-Chiari Syndrome

目的:分析布-加综合征的横轴位CT表现,并与肝硬化CT表现对照,提高该病的诊断准确率。方法:对经血管造影或CTA等多种影像诊断或证实的48例布加综合征的CT表现进行回顾性分析,同时选择48例乙肝后肝硬化的患者进行对照,分析两种病变在横轴位CT表现上的差异,并采用卡方检验进行统计处理。结果:布加综合征CT表现为尾状叶肿大28例,明显高于肝硬化患者的5例(p<0.05);左叶增大在肝硬化患者为40例,高于布加综合征患者的14例(p<0.05)肝脏周边部分及肝内门静脉分支区域在动脉期明显强化21例,门静脉期肝实质呈不均匀花斑状强化为46例,肝硬化患者未见上述表现(p<0.01);侧枝循环中心包膈静脉的开放在布加综合征23例,在肝硬化患者未显示(p<0.01)。结论:增强CT的横轴位表现对布-加综合征的诊断有很重要的提示作用。

Objective：To evaluate the effect of contrast-enhanced CT axial images for the diagnosis of Budd-Chiari Syndrome（BCS） by comparing the CT appearances of BCS and liver cirrhosis（LC） . Methods：Forty-eight patients with BCS who diagnosed by angiography,surgery or imaging methods（ultrasound,CTA and MRA） were retrospectively reviewed,and 48 patients with liver cirrhosis were selected as a control group. The differences of CT appearances in BCS and liver cirrhosis were assessed by using chi-square test. Results：The caudate lobe enlargement was found in 28 BCS patients and higher than that of LC（14） （p〈0.05） ;The left lobe enlargement was in 40 LC patients,while in 14 MCS patients（P〈0.01） . The parenchymal enhancement surrounding portal vein and peripheral hepatic area on arterial phase was found in 21 MCS cases,and the hepatic heterogeneous enhancement on portal vein phase was found in 46 MCS cases,no such appearances in LC cases. Pericardiacophrenic veins were found in 23 MCS cases,and not in LC patients. Conclusion：The CT appearances of MCS on contrast-enhanced axial images are different from that of liver cirrhosis and suggestive for the diagnosis of BCS.