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作 者:武明辉[1] 徐俊玲[1] 史大鹏[1] 申皓 王梅云[1] 李永丽[1] 韩新巍[3]
机构地区:[1]河南省人民医院放射科,河南郑州4500032 [2]GE医疗公司,北京100176 [3]郑州大学第一附属医院介入科,河南郑州450052
出 处:《中国医学影像学杂志》2015年第1期30-34,40,共6页Chinese Journal of Medical Imaging
基 金:国家临床重点专科建设项目
摘 要:目的探讨非增强MR血管成像(NCE-MRV)在布加综合征(BCS)诊断中的应用价值。资料与方法 35例怀疑BCS患者均行NCE-MRV和数字减影血管造影(DSA)检查,比较两者的一致性,并计算NCE-MRV的诊断敏感度、特异度、准确度、阴性预测值及阳性预测值。结果 35例患者中,32例DSA诊断为BCS,33例NCE-MRV诊断为BCS,DSA显示下腔静脉膜性狭窄8例(NCE-MRV10例),膜性阻塞7例(NCE-MRV 6例),节段性狭窄3例(NCE-MRV 4例),节段性阻塞10例(NCE-MRV 10例),下腔静脉血栓5例(NCE-MRV 5例)。NCEMRV诊断BCS的敏感度为100.0%,特异度为67.8%,准确度为97.1%,阴性预测值为100.0%,阳性预测值为96.9%。NCE-MRV与DSA相比较具有良好的一致性(Kappa=0.89)。NCE-MRV显示肝内侧支血管30例,肝外侧支血管27例,副肝静脉25例。结论 NCE-MRV对于BCS下腔静脉病变的诊断与DSA对比有良好的一致性,可以作为BCS可疑患者诊断下腔静脉阻塞的无创检查手段。Purpose To evaluate the diagnostic value of non-contrast-enhanced MR venography (NCE-MRV) for Budd-Chiari syndrome (BCS). Materials and Methods NCE-MRV and digital subtraction angiography (DSA) examination were performed in thirty-five patients with suspected BCS. The diagnostic agreement between them were compared. The sensitivity, specificity, accuracy, negative predictive value and positive predictive value were also calculated. Results In all 35 patients, 32 were diagnosed as BCS on DSA, and 33 on NCE-MRV. DSA showed inferior vena cava membrane stenosis in 8 patients compared to 10 on NCE-MRV; membrane obstruction in 7 compared to 6 on NCE-MRV, segmental stenosis in 3 compared to 4 on NCE-MRV; segmental obstruction in 10 compared to 10 on NCE-MRV, 1VC thrombosis in 5 compared to 5 on NCE-MRV. The sensitivity, specificity, accuracy, negative predictive value and positive predictive value of NCE-MRV in diagnosing BCS were 100.0%, 67.8%, 97.1%, 100.0% and 96.9%, respectively. There was good intra-modality agreement (Kappa=0.89). NCE-MRV also demonstrated intra-hepatic collaterals in 30 patients, extra-hepatic collaterals in 27 cases, and accessory hepatic veins in 25 cases. Conclusion NCE-MRV has excellent diagnostic agreement with DSA in diagnosing interior vena cava lesion in patients with BCS. It may be used in noninvasive diagnosis.
关 键 词:BUDD-CHIARI综合征 磁共振血管造影术 血管造影术 数字减影 腔静脉 下 肝静脉
分 类 号:R445.3[医药卫生—影像医学与核医学] R322[医药卫生—诊断学]
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