磁共振静脉血管成像诊断布-加综合征下腔静脉阻塞性质的价值  

The significance of high-field magnetic resonance in the diagnosis of inferior vena cava obstruction in Budd-Chiari syndrome

作　　者：路欣[1] 徐凯[1] 顾玉明[1] 杨春[1] 李绍东[1] 王小龙[1] 李曾[1] 张庆桥[1] 祖茂衡[1] 

机构地区：[1]徐州医学院附属医院影像科,江苏徐州221002

出　　处：《徐州医学院学报》2013年第12期860-863,共4页Acta Academiae Medicinae Xuzhou

基　　金：江苏省临床医学科技专项——新型临床诊疗技术攻关项目（BL2012044）,肝静脉及下腔静脉阻塞端形态的磁共振静脉成像研究（2012-2015）;徐州医学院振兴计划资助（2012）

摘　　要：目的 评价高场强磁共振诊断布-加综合征下腔静脉阻塞的价值.方法 51例布-加综合征患者行磁共振静脉血管成像（M RV）检查,以DSA为金标准,评价下腔静脉阻塞端的性质.结果 51例布-加综合征患者中MRV显示下腔静脉完全阻塞37例,不完全阻塞14例;节段性阻塞14例,节段性狭窄3例;膜性阻塞23例,膜性带孔狭窄10例.DSA显示完全阻塞38例,不完全阻塞13例;节段性阻塞13例,节段性狭窄4例;膜性阻塞24例,膜性带孔狭窄9例.MRV正确显示其中不完全阻塞12例.以DSA为金标准,MRV诊断下腔静脉阻塞性质的灵敏度为97.4％、特异度为92.3％、阳性预测值为97.4％、阴性预测值为92.3％.结论 MRV诊断布-加综合征下腔静脉阻塞类型有重要价值,术前准确诊断阻塞段类型有助于指导介入治疗方案的制订.Objective To evaluate the diagnostic value of high - field magnetic resonance on the inferior vena cava obstruction in Budd - Chiari syndrome （BCS）. Methods Megnetie resonance venography （MRV） was performed on 51 cases of BCS and the blocking properties of the inferior vena cava obstruction was evaluated using DSA as golden standard. Results In all 51 cases, there were 37 cases with complete obstruction and 14 cases with incomplete obstruction. MRV showed segmental occlusion in 14 cases, segmental stenosis in 4 cases, membranous obstruction in 33 cases, perforated membrane obstruction in 10 cases. The overall sensitivity, specificity, positive and negative predictive values for the diagnosis of MRV were 97.4%, 92.3%, 97.4, and 92.3% respectively as compared to the DSA. Conclusion MRV imaging is a better judgment screening method to evaluate the blocking properties of the inferior vena cava obstruction. Accurate preoperative diagnosis of obstructive segment oeelusion types is helpful for the formulation of interventional treatment plan.

关 键 词：布-加综合征 腔静脉 下 肝静脉 磁共振静脉血管成像 

分 类 号：R543.6[医药卫生—心血管疾病]