急慢性布加综合征MRI特征对照研究  

Comparative study on MRI features of acute and chronic Budd-Chiari syndrome

作　　者：成德雷[1] 徐浩[1] 华荣[2] 祖茂衡[1] 徐凯[2] 路欣[2] 张庆桥[1] 鹿彩銮[2] 杜洪涛[1] 仇焕[3] 徐新建[1] 

机构地区：[1]江苏省徐州医学院附属医院介入放射科,221002 [2]江苏省徐州医学院附属医院放射科,221002 [3]江苏省徐州医学院附属医院超声室,221002

出　　处：《中华放射学杂志》2013年第9期816-819,共4页Chinese Journal of Radiology

基　　金：江苏省“十二五”期间“科教兴卫工程”项目资助（LJ201143）;江苏省“临床医学科技专项”项目资助（BL2012044）

摘　　要：目的研究急、慢性布加综合征（BCS）MRI特征，探讨MRI对急、慢性BCS的诊断价值。方法以11例急性BCS患者作为急性组，以同期连续收治的42例慢性BCS患者作为慢性组。回顾性分析两组患者MR检查结果。腹水量两组间比较采用WilcoxonW秩和检验；肝内外交通支形成比例两组间比较采用Fisher确切概率法。结果急性组MR检查均发现T：WI高信号的肝静脉血栓，其中3例患者合并下腔静脉血栓；与肝脏中央区相比，肝脏外周带T1WI均呈稍低信号，T2WI均为稍高信号，动态增强扫描时动脉期及静脉期强化程度均相对较低。慢性组中单纯下腔静脉阻塞3例，单纯肝静脉阻塞9例，肝静脉和下腔静脉联合受累30例，仅有3例患者下腔静脉内可发现T2WI高信号的静脉血栓。慢性组患者均示淤血性肝硬化征象。MR平扫及增强扫描时，慢性BCS患者肝脏外周带与中央区信号无明显差异。急性组均有腹水形成（中等量腹水2例、大量腹水9例），慢性组中22例（52．4％）患者腹水形成（少量腹水15例、中等量腹水2例、大量腹水5例），急性组腹水发生率高于慢性组（Z=4．15，P〈0．01）；急性组肝内交通支形成2例、肝外交通支1例，慢性组肝内交通支形成37例、肝外交通支形成34例，急性组中肝内及肝外交通支形成患者比例均低于慢性组（P均〈0．01），以上各指标组间差异均有统计学意义。结论MRI能准确显示BCS的各种直接征象及间接征象，能够对急、慢性BCS做出准确诊断。Objective To investigate the features of Magnetic resonance imaging （MRI） and analyze the diagnostic value of MRI on acute and chronic Budd-Chiari syndrome（BCS）. Methods Eleven patients with acute BCS who were treated, while other 42 patients with proven chronic BCS were taken as chronic group. All patients in our study underwent MRI examinations. MRI findings were retrospectively studied. Comparison between groups was made by Wilcoxon W rank sum test for frequency of ascites and Fisher Exact Test for the percentage of intrahepatic venous collaterals and extrahepatic venous collaterals. Results Hepatic venous thrombosis with high signal on TzWI was demonstrated in 11 patients with acute BCS, and 3 of them also had inferior vena cava thrombosis. Compared with the central liver, the periphery of the liver of all patients were moderately hypointensive on T1WI and slightly hyperintensive on T2WI, and the enhancement degree of liver periphery in venous phase and arterial phase was relatively low. In chronic group, 9 of them had hepatic venous obstruction, 3 had inferior vena cava obstruction, and 30 had both. All chronic BCS patients had the features of stasis cirrhosis. There was no signal difference between the periphery and the central of the liver on precontrast and postcontrast images. In acute group, all of them suffered from ascites （2 patients with a moderate amount of ascites, and 9 patients with massive ascites） , 2 of them had intrahepatic venous collaterals, one had extrahepatic venous collaterals. But in chronic group, 22 of them suffered from ascites （ A small amount of ascites in 15 patients, 2 patients had a moderate amount of ascites, and 5 patients had massive ascites ）, and 37 of them were found with intrahepatic venous collaterals, 34 of them were with extrahepatic venous collaterals. The incidence of ascites in the acute group was higher than that in the chronic group （Z =4. 15 ,P 〈0. 01 ）, and the percentage of intrahepatic venous collaterals and extrahepatic venous collater

关 键 词：布加综合征 磁共振成像 急性 慢性 肝静脉血栓形成 

分 类 号：R445.2[医药卫生—影像医学与核医学] R575[医药卫生—诊断学]