Budd—Chiari综合征多层螺旋CT动态增强扫描及CT血管成像分析  

Dynamic Enhancement Findings with Multi-slice Spiral CT and CT Angiography in Budd-Chiari Syndrome

作　　者：李宏军[1] 杨铁[1] 

机构地区：[1]解放军总医院放射诊断科,北京100853

出　　处：《中国医学影像学杂志》2008年第5期350-352,共3页Chinese Journal of Medical Imaging

摘　　要：目的:探讨Budd-Chiari综合征(BCS)肝脏多层CT动态增强规律,分析多层螺旋CT动态增强扫描及CT血管成像(CTA)技术在BCS诊断中的应用价值。材料和方法:回顾性分析45例BCS的多层螺旋CT动态增强扫描图像,并进行血管重建,分析BCS的多层螺旋CT动态增强规律,评价其在判断血管梗阻平面及显示肝内、外侧支循环中的价值。结果:45例中,肝静脉阻塞(狭窄)26例(57.8%)、下腔静脉阻塞(狭窄)6例(13.3%)和肝静脉合并下腔静脉阻塞(狭窄)13例(28.9%)。布-加综合症肝实质典型的增强方式表现为首先出现在肝门区和尾状叶的、以肝内门静脉小支为中心的斑片状增强,随时间延迟增强范围逐渐扩大(29例)。结论:螺旋多层CT动态增强扫描能够准确地反映BCS患者肝脏血流动力学变化,结合CTA技术,能够更直观、准确地显示血管梗阻平面及肝内、外侧支循环。Purpose： To investigate the dynamic enhancement regulations of liver in Budd-Chiari syndrome（BCS） by using multi-slice CT and evaluate the value of CT angiography in the diagnosis of BCS. Materials and Methods： 45 cases with BCS were retrospectively ana- lyzed. All patients underwent dynamic enhancement examinations with multi-slice CT. The relevant vessels were reconstructed respectively with MIP, VR and MPR. Estimated the value of dynamic enhancement CT exams and CTA techniques in judging the obstruction level and showing collateral vessels. Results： Of all 45 cases, 26 cases （ 57.8 % ） had hepatic vein obstructions, 6 cases （ 13.3 % ） were simple obstruction of inferior vena cava; 13 cases（28.9% ） were obstruction of both hepatic vein and inferior vena cava. Most cases displayed typical patchy enhancement of the parenchyma firstly appeared in hepatic hilum area and caudate lobe, and the range of patchy enlarged gradually. Conclusions： Dynamic enhancement examinations with multi-slice CT can correctly reflect the hepatic hemodynamic changes. Transverse images, combined with CTA, can explicitly display the obstruction level of Vascular lesions and collateral circulations in BCS.

关 键 词：Budd—Chiari综合征 多层螺旋CT CT血管造影术 

分 类 号：R816.5[医药卫生—放射医学]