多排螺旋CT及彩色多普勒超声在布加综合征分型诊断中的应用价值

The Preoperative Type Value of Applying MSCT and Color Doppler Ultrasound of Budd-Chiari Syndrome

为探讨多排螺旋CT(MSCT)及彩色多普勒超声对布加综合征(Budd-Chiari Syndrome,BCS)的术前分型应用价值,回顾性分析了经数字减影造影(DSA)或手术证实的63例BCS患者的临床资料及MSCT、彩色多普勒超声等影像学表现.MSCT诊断结果表明:63例BCS患者中下腔静脉全部或部分阻塞15例(23.8%),肝静脉阻塞30例(47.6%),混合型18例(28.6%);诊断符合率为100%,63例病例均出现肝内或肝外侧支静脉循环.超声诊断结果显示:63例BCS患者中,被多普勒超声诊断为BCS的患者为55例(其中肝静脉阻塞25例,下腔静脉型12例,混合型18例),漏诊8例;超声诊断符合率为87.3%.因此,MSCT是诊断BCS的有效检查方法,对BCS的术前分型具有重要参考价值;彩色多普勒超声可以作为BCS的基本筛查手段.

To investigate the preoperative type value of multi-slice CT （MSCT） and color Doppler ultra- sound of Budd-Chiari syndrome （BCS）, we conduct a retrospective analysis of clinical data, including MSCT and colour Doppler ultrasound imaging data from 63 patients of BCS confirmed by DSA or surgery. MSCT dignostic results showed that among 63 patients with BCS, there were partial or total obstruction of the inferior vena cava （n = 15,23.8 %）, hepatic vein obstruction （n = 30,47.6 %）, and mixed type （n = 18, 28.6%） ;the dignostic coincidence rate of MSCT was 100% ,and intrahepatic or extrahepatic collateral ve- nous circulation were found in all the 63 patients. Ultrasound diagnosis results showed that 55 cases were found with color Doppler ultrasound in the diagnosis of BCS patients, including 25 cases of hepatic vein ob- struction,12 cases of inferior vena cava type, 18 cases of mixed type,and 8 cases were misdiagnosed; the dignostic coincidence rate of ultrasound was 87.3%. MSCT is an effective inspection method for diagnosis of BCS, and is an important reference of the BCS preoperative classification. Color doppler ultrasound can be used as basic screening method of BCS.