Diagnostic Value of 64 Slice Spiral Computed Tomography for Budd-Chiari Syndrome_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

CHEN Guangwen , CHEN Litao , SONG Bin , YUAN Fang , ZHANG Xie

Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, ChinaCorresponding Author: SONG Bin, E-mail: cjr.songbin@vip.163.com;

Corresponding author：

Keywords：

Budd-Chiari syndrome; Liver; Tomography/X-ray computed; Angiography; Diagnosis

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Objective 　To investigate the imaging features of Budd-Chiari syndrome (BCS) on 64 slice spiral computed tomography (64SCT) and the diagnostic value of 64SCT for BCS.
Methods 　Twenty-nine patients diagnosed as BCS by 64SCT were retrospectively included into this study and all the patients were researched by digital substraction angiography (DSA). Two abdominal radiologists analyzed the CT imaging features of BCS, paying attention to the vascular lesion, the morphology abnormality of the liver and the degree of portal hypertension, with review of DSA findings.
Results 　①The accuracy of 64SCT for BCS was 93.1% (27/29), and there were 2 false positive cases and no false negative case. The accuracy of 64SCT for those patients with thrombosis of inferior vena cava (IVC) and (or) hepatic vein (HV) was high as compared to those with stenosis of IVC and (or) HV. ②The morphology abnormality of the liver included hepatomegaly (24 cases), low attenuation (27 cases) and inhomogeneous pattern of parenchymal contrast enhancement (5 patients in arterial phase and 19 patients in portal vein phase). ③The images of all the patients showed the features of portal hypertension.
Conclusion 　The accuracy of 64SCT for BCS is satisfactory and the false negative is seldom. The 64SCT could accurately display the morphology abnormality of the liver and the compensatory circulation in BCS patients. For those patients with stenosis of IVC and (or) HV, however, the diagnostic power of 64SCT is limited.

Citation： CHEN Guangwen,CHEN Litao,SONG Bin,YUAN Fang,ZHANG Xie. Diagnostic Value of 64 Slice Spiral Computed Tomography for Budd-Chiari Syndrome. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2009, 16(9): 763-767. doi: Copy

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11.	王翠艳, 刘学静, 王克, 等. 多层CT血管成像技术对布加综合征的诊断价值 [Ｊ]. 中国现代普通外科进展, 2008; 11(3): 255-257.
12.	王佾, 张辉, 郭成浩, 等. 下腔静脉隔膜阻塞型布-加综合征的病理学及病因学研究 [Ｊ]. 介入放射学杂志, 2008; 17(7): 500-503.
13.	刘军, 靳祖涛, 王占民, 等. 布加氏综合征外科治疗78例报告 [Ｊ]. 中国普外基础与临床杂志, 2000; 7(3): 164-166.
14.	魏志新. 肠腔分流或联合下腔静脉内支架置入术治疗布-加氏综合征 [Ｊ]. 中国普外基础与临床杂志, 2001; 8(4): 265-266.
15.	Gailloud P, Oishi S, Carpenter J, et al. Three-dimensional digital angiography: new tool for simultaneous three-dimensional rendering of vascular and osseous information during rotational angiography [Ｊ]. AJNR Am J Neuroradiol, 2004; 25(4): 571-573.
16.	Vilgrain V, Lewin M, Vons C, et al. Hepatic nodules in Budd-Chiari syndrome: imaging features [Ｊ]. Radiology, 1999; 210(2): 443-450.
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18.	吴苾, 宋彬. 肝硬变结节性病变的影像学和相关病理学表现 [Ｊ]. 中国普外基础与临床杂志, 2003; 10(3): 288-294.
19.	Dilawari JB, Bambery P, Chawla Y, et al. Hepatic outflow obstruction (Budd-Chiari syndrome). Experience with 177 patients and a review of the literature [Ｊ]. Medicine (Baltimore), 1994; 73(1): 21-36.
20.	Lu CL, Chou YH, Hwang SJ, et al. Membranous obstruction of inferior vena cava in Taiwan [Ｊ]. J Gastroenterol Hepatol, 1995; 10(3): 287-294.

1. Brancatelli G, Vilgrain V, Federle MP, et al. Budd-Chiari syndrome: spectrum of imaging findings [Ｊ]. AJR Am J Roentgenol， 2007; 188(2): W168-W176.
2. 李枫, 王峰, 纪东华, 等. 布-加综合征的影像诊断及综合介入治疗 [Ｊ]. 中国医学影像技术, 2008; 24(增刊): 192-194.
3. 汪忠镐, 李震. 我国血管外科的现状和发展 [Ｊ]. 中国普外基础与临床杂志, 2006; 13(6): 625-628.
4. 孟庆义. 布加综合征介入治疗与外科手术: 外科医师的选择 [Ｊ]. 介入放射学杂志, 2008; 17(4): 299-302.
5. 高雪梅, 韩新巍, 马波, 等. CT对布-加综合征的病变血管的诊断价值 [Ｊ]. 实用放射学杂志, 2006; 22(7): 881-883.
6. Aydinli M, Bayraktar Y. Budd-Chiari syndrome: etiology, pathogenesis and diagnosis [Ｊ]. World J Gastroenterol, 2007; 13(19): 2693-2696.
7. 陈光文, 宋彬, 陈坜桃, 等. 淤血性肝硬变的MSCT、MRI诊断价值 [Ｊ]. 中国普外基础与临床杂志, 2009; 16(6): 495-499.
8. Lupescu IG, Dobromir C, Popa GA, et al. Spiral computed tomography and magnetic resonance angiography evaluation in Budd-Chiari syndrome [Ｊ]. J Gastrointestin Liver Dis, 2008; 17(2): 223-226.
9. 马秀华, 吕富荣, 尤云峰, 等. 布加综合征的多层螺旋CT诊断 [Ｊ]. 第三军医大学学报, 2008; 30(20): 1914-1917.
10. 纪建松, 章士正, 赵中伟, 等. Budd-Chiari综合征的CT、MRI诊断价值 [Ｊ]. 实用放射学杂志, 2007； 23(9): 1201-1203.
11. 王翠艳, 刘学静, 王克, 等. 多层CT血管成像技术对布加综合征的诊断价值 [Ｊ]. 中国现代普通外科进展, 2008; 11(3): 255-257.
12. 王佾, 张辉, 郭成浩, 等. 下腔静脉隔膜阻塞型布-加综合征的病理学及病因学研究 [Ｊ]. 介入放射学杂志, 2008; 17(7): 500-503.
13. 刘军, 靳祖涛, 王占民, 等. 布加氏综合征外科治疗78例报告 [Ｊ]. 中国普外基础与临床杂志, 2000; 7(3): 164-166.
14. 魏志新. 肠腔分流或联合下腔静脉内支架置入术治疗布-加氏综合征 [Ｊ]. 中国普外基础与临床杂志, 2001; 8(4): 265-266.
15. Gailloud P, Oishi S, Carpenter J, et al. Three-dimensional digital angiography: new tool for simultaneous three-dimensional rendering of vascular and osseous information during rotational angiography [Ｊ]. AJNR Am J Neuroradiol, 2004; 25(4): 571-573.
16. Vilgrain V, Lewin M, Vons C, et al. Hepatic nodules in Budd-Chiari syndrome: imaging features [Ｊ]. Radiology, 1999; 210(2): 443-450.
17. Maetani Y, Itoh K, Egawa H, et al. Benign hepatic nodules in Budd-Chiari syndrome: radiologic-pathologic correlation with emphasis on the central scar [Ｊ]. AJR Am J Roentgenol, 2002; 178(4): 869-875.
18. 吴苾, 宋彬. 肝硬变结节性病变的影像学和相关病理学表现 [Ｊ]. 中国普外基础与临床杂志, 2003; 10(3): 288-294.
19. Dilawari JB, Bambery P, Chawla Y, et al. Hepatic outflow obstruction (Budd-Chiari syndrome). Experience with 177 patients and a review of the literature [Ｊ]. Medicine (Baltimore), 1994; 73(1): 21-36.
20. Lu CL, Chou YH, Hwang SJ, et al. Membranous obstruction of inferior vena cava in Taiwan [Ｊ]. J Gastroenterol Hepatol, 1995; 10(3): 287-294.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Diagnostic Value of 64 Slice Spiral Computed Tomography for Budd-Chiari Syndrome

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