彩色多普勒超声在Budd—Chiari综合征的诊断价值

The Diagnostic Value of Color Doppler Ultrasonography in Budd-Chiari Syndrome

目的:探讨Budd-chiari综合征(B-CS)的特征性异常血管形态及其血流的变化。方法:对85例B-CS患者的肝静脉、下腔静脉。进行彩色多普勒超声分析。结果:85例B-CS其下腔静脉狭窄52例,闭塞9例;肝静脉狭窄102支,闭塞61支,其肝静脉间均见多条侧支血管;肝静脉血流经侧支血管流入未闭的肝静脉或经肝尾叶静脉及其他扩张的静脉分流入下腔静脉;下腔静脉闭塞时血流亦可逆向分流入肝静脉。结论:肝静脉、下腔静脉狭窄和闭塞及肝静脉间侧支血管形成是B—CS特征性异常血管形态;彩色多普勒超声可依据其特征性异常血管的病变类型、阻塞部位、梗阻程度和范围、侧支循环径路及血流动力学特点准确诊断B-CS。并作为首选检查方法。

Objective To investigate the characteristically abnormal vascular sharps in Budd-Chiari syndrome (B-CS), and the changes of blood flow.Methods The hepatic veins and inferior cave veins of 85 B-CS patients were evaluated with color Doppler ultrasonography.Results In the 85 B-CS patients,52 had narrowed and 9 had closed inferior vena cava;102 hepatic veins were found narrowed and 61 closed with several collateral blood vessels through which some hepatic venous blood flowed to the un-closed hepatic veins,some hepatic venous blood shunted through hepatic sinistrac veins or other enlarged veins into inferior vena cave.In the cases of closed inferior vena cave,the blood in inferior vena cava can alsore-shunt to hepatic veins.Conclusion Narrowed or closed inferior vena cave and collateral-vessel formation are characteristic abnormal vascular sharps in B-CS;with color Doppler ultrasonography,which should be used as the first-choosing examination,accurate diagno- sis can be made based on its characteristic abnormal vascular changes such as types of abnormal vessel,blocking location,area, severity,collateral circulation and hemodynamic.