摘要
目的观察三维对比剂增强 MR 血管成像(3D CE MRA)上布加综合征(BCS)的各种表现,并初步评价该项新技术的价值。方法 33例 BCS 患者行3D CE MRA 检查。23例为继发性BCS,分别继发于肝细胞癌(21例)、右肾上腺癌(1例)或血栓性静脉炎(1例)。10例为原发性 BCS。观察肝静脉、下腔静脉(IVC)和门静脉的开放性,观察有无肝内外侧支、肝实质病变和门静脉-体静脉间曲张静脉。10例患者行下腔静脉造影术,2例行肝右静脉穿刺造影术,把3D CE MRA 所获的诊断结果与造影相对照。结果 3D CE MRA 可显示 BCS 的各种表现。肝静脉表现包括:癌栓形成(19例)、肿瘤压迫(2例)、肝静脉未显示(4例)和局限性狭窄(4例)。IVC 表现为严重狭窄或闭塞(10例)、肿瘤直接侵犯(2例)、癌栓形成(3例)、血栓性静脉炎(1例)和隔膜形成(3例)。9例显示肝内侧支形成,其中2例显示“蜘蛛网”征象。所见的肝外侧支包括扩张的奇静脉和半奇静脉(13例),以及左肾-膈下-心包膈静脉侧支(2例)形成。2例患者发现门静脉左支闭塞,10例患者发生门静脉-体静脉间静脉曲张。3D CE MRA 发现的肝实质病变有:尾叶增大(7例)、不均匀强化(18例)和并发肿瘤(18例)。12例3D CE MRA 诊断结果均与造影结果一致。结论 3D CE MRA 能显示BCS 的各种征象,并能帮助提供正确诊断。
Objective To assess the various features of Budd-Chiari syndrome （BCS） on threedimensional contrast-enhanced magnetic resonance angiography （3D CE MRA） and to evaluate the potential value of this new technique. Methods Thirty-three patients with BCS underwent 3D CE MRA examination. In 23 cases, BCS was secondary to hepatocellular carcinoma （21 patients ） or right adrenal carcinoma （1 patient） or thrombophlebitis （1 patient）. Ten patients had primary BCS. The patency of the hepatic veins, inferior vena cava （IVC） and portal veins were assessed. The presence of intra- and extrahepatic collaterals, liver parenchymal abnormalities and porto-systemic varices were evaluated. The diagnosis on 3D CE MRA was correlated with that on inferior vena cavography and right hepatic venography, which were available in 10 and 2 cases respectively. Results Various features of BCS were displayed on 3D CE MRA. Hepatic venous findings included tumor thrombosis （19 patients ）, tumor compression （2 patients ）, nonvisualization （4 patients） and focal stenosis （4 patients） of the hepatic veins. IVC findings were severe stenosis or occlusion （10 cases）, tumor direct invasion （2 cases ）, tumor thrombosis （3 cases）, thrombophlebitis （1 case ） and web formation （3 cases ）. Intrahepatic collaterals were demonstrated in 9 patients including 2 with ＂spider web＂ sign. Detected extrahepatic collaterals included dilated azygos and hemiazygos veins （ 13 cases ） and left renal-inferior phrenic-pericardiophrenic collaterals （ 2 cases ）. The occlusion of the left portal vein and the presence of porto-systemic varices were depicted in 2 and 10 patients respectively. Liver parenchymal abnormalities identified by 3D CE MRA consisted of caudate lobe enlargement （7 cases）, heterogenous enhancement （18 cases） and associated tumors （18 cases）. Compared with inferior vena cavography and hepatic venography, the accuracy of 3D CE MRA in the diagnosis of IVC obstruction or hepatic venous stenosis was 100%. Conclusion 3D CE MRA can display various features of BCS and has the potential to provide an accurate diagnosis.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2006年第10期1071-1074,共4页
Chinese Journal of Radiology
关键词
肝静脉血栓形成
磁共振血管造影术
Hepatic vein thrombosis
Magnetic resonance angiography
