彩色多普勒超声在布加综合征诊断中的应用

The diagnostic value of ultrasound for Budd-Chiari syndrome

目的探讨彩色多普勒超声对布加综合征的诊断价值。方法应用彩色多普勒超声,分析34例布加综合征二维超声及血流声像图特点。结果 34例布加综合征中,直接征象显示下腔静脉膈膜型狭窄7例(20.6%),肝静脉或下腔静脉隧道型狭窄或闭塞18例(52.9%),下腔静脉内血栓或肿瘤4例(11.8%),外压型布加综合征5例(14.7%),均在超声下得到很好的显示;而间接征象主要表现为肝硬化和肝静脉间交通支,发生率分别为76.5%(26例)和91.2%(31例)。结论彩色多普勒超声能够明确显示布加综合征受累血管病变部位、范围、类型,可为临床诊疗提供可靠的诊断信息。而间接征象的出现可为诊断提供辅助证据。

Objective To investigate diagnostic value of ultrasound for Budd-Chiari syndrome（ BCS）. Methods The gray and blood flow characteristics of 34 patients with BCS were analyzed by two-dimensional gray ultrasound and color Doppler ultrasound.Results Direct signs and indirect signs were displayed well by ultrasound in the 34 Budd-Chiari syndrome cases. The direct signs included： Inferior vena cava membranous stenosis（ 7 cases,20. 6%）; hepatic vein or inferior vena cava tunnel-type stenosis or occlusion（ 18 cases,52. 9%）; tumor or thrombus within the inferior vena cava（ 4 cases,11. 8%）; external pressure type（ 5 cases,14. 7%）. And the indirect signs were displayed as cirrhosis（ 26 cases,76. 5%） and the collaterals between hepatic venous（ 31 cases,91. 2 %）. Conclusion Ultrasound can clearly define BCS vascular lesion location,range and types,and can accurately reflect the inferior vena cava,hepatic venous blood flow direction. Ultrasound can offer reliable information for clinical diagnosis and treatment. The emergence of indirect signs can provide valuable supporting evidence for the diagnosis.