彩色多普勒超声在布加综合征诊断中的价值

Effect of Color Doppler Ultrasonograpy in the Diagnosis of Budd-Chiari Syndrome

目的探讨布加综合征的超声声像图特征,特别是彩色多普勒超声的诊断价值。方法对22例经下腔静脉造影或经皮肝静脉穿刺造影确诊的布加综合征患者的超声检查进行回顾性分析。除常规二维超声表现外,重点记录患者的彩色多普勒超声特点,并以造影结果为金标准,计算超声诊断的敏感性和特异性。结果22例患者中,肝静脉狭窄或闭塞型5例(Ⅰ型),下腔静脉阻塞或闭塞型(Ⅱ型)15例,肝静脉和下腔静脉混合性病变(Ⅲ型)2例。二维声像图表现为肝静脉及下腔静脉管壁增厚,致狭窄或闭塞,肝静脉间交通支形成;彩色多普勒超声显示肝静脉、下腔静脉异常的血流情况;频谱多普勒超声显示肝静脉、下腔静脉低速、平坦、单向的血流流速曲线。本组彩超诊断正确率约90.91%。结论彩色多普勒超声检查可以确定布加综合征血管病变的部位、范围及类型,准确反映下腔静脉、尤其是肝静脉的血流方向及流速曲线的变化,对减少误诊为肝硬化提供可靠的诊断信息。

Objective To discuss ultrasound features ,especial Color Doppler features of Budd--Chiari syndrome. Methods Retrospec- tively analyzed were ultrasound findings in 22 patients of Budd--Chiari syndrome that were confirmed by angiography of inferior vena cava. The features of Color Doppler were recorded for discussing the specificity and accuracy of Ultrasonograpy dignosis of Budd-- Chiari syndrome. Results The obstruction of hepatic vein was found in 5 cases and the obstruction of inferior venae cava in 15 cases.Both of the two vein obstruction were found in 3 cases.Comparing with Two-Dimensional Ultrasound,Color Doppler was more special and accurate. Conclusion Color Doppler was special and accurate in dianosis of Budd--Chiari syndrome and decreased the proportion of wrong diagnosis.