3.0 T MRV辅助DSA介入治疗布加综合征患者效果临床研究

Auxiliary assistance of MR venography for DSA-guided interventional therapy in the treatment of patients with Budd-Chiari syndrome

目的研究3.0 T磁共振静脉成像(MRV)辅助数字减影血管造影(DSA)下治疗布加综合征(BCS)患者的临床疗效。方法2014年3月~2019年3月我院收治的120例BCS患者,接受3.0 T MRV检查,并在此成像指导下行DSA下介入治疗。结果MRV检查下腔静脉闭塞端危险交通支和闭塞端形态显示率分别为7.5%和25.0%,显著低于DSA检查的40.0%和60.0%(P<0.05),对肝静脉各支(右、中、左)和副肝静脉显示率分别为95.0%、80.0%、75.0%和52.5%,显著高于DSA检查的40.0%、35.0%、30.0%和17.5%(P<0.05),对下腔静脉节段狭窄、下腔静脉闭塞、下腔静脉膜性带孔和血栓显示率与DSA造影比较差异均无统计学意义(P>0.05);120例患者经介入治疗均获得成功,其中21例(17.5%)经股静脉入路,63例(52.5%)经右股静脉和右颈内静脉双向入路,3例(2.5%)经皮肝穿刺肝静脉联合颈内静脉双入路,33例(27.5%)经右颈内静脉入路。结论采用3.0 T MRV检查能清晰地显示BCS患者血管阻塞情况,弥补DSA造影的不足,对介入诊疗有很大的辅助作用。

Objective The aim of this study was to investigate the auxiliary assistance of MR venography(MRV)for digital subtraction angiography(DSA)-guided interventional therapy in the treatment of patients with Budd-Chiari syndrome(BCS).Methods 120 patients with BCS were admitted to our hospital between March 2014 and March 2019,and underwent 3.0 T MRV.All patients received interventional therapy under DSA guidance.Results The MRV showed 7.5%and 25.0%of the dangerous communicating branches and occlusive ends of inferior vena cava,significantly lower than 40.0%and 60.0%by DSA(P<0.05),and 95.0%,80.0%,75.0%and 52.5%of right,middle and left branches of hepatic vein,and accessory hepatic vein,respectively,all significantly higher than 40.0%,35.0%,30.0%and 17.5%by DSA(P<0.05),while there were no significant differences as for the demonstration of segment of inferior vena cava,stenosis,inferior vena cava occlusion,inferior vena cava membranous formation and thrombosis by the two methods(P>0.05);the interventional therapy was successful in 120 patients,for which,21 cases(17.5%)by via femoral vein,63 cases(52.5%)via right femoral veinand right internal jugular vein,3 cases(2.5%)via percutaneous hepatic vein combined with internal jugular vein,and 33 cases(27.5%)via right internal jugular vein.Conclusion The MRV could clearly show the obstruction of blood vessels in patients with Budd-Chiari syndrome before interventional therapy,which might help the correct operation under DSA angiography in clinical practice.