3．0T磁共振静脉血管成像在布加综合征介入治疗中对阻塞血管的评估  

Assessment of 3.0T MRV evaluation on vascular obstruction for interventional therapy in Budd- Chiari syndrome

作　　者：夏风飞[1] 魏宁[1] 祖茂衡[1] 徐浩[1] 顾玉明[1] 张庆桥[1] 王文亮[1] 吕墩涛[1] 

机构地区：[1]江苏省徐州医学院附属医院介入放射科,221006

出　　处：《中华肝胆外科杂志》2015年第12期793-797,共5页Chinese Journal of Hepatobiliary Surgery

基　　金：江苏省医学创新团队：布-加综合征的基础及介入治疗研究（LJ201143）;江苏省临床医学科技专项：布加综合征介入诊疗规范化研究（BL2012021）;江苏省徐州医学院“振兴计划”项目（XZMC20122015）

摘　　要：目的探讨3．0T磁共振静脉成像（MRV）在布加综合征（BCS）患者介入治疗中对阻塞血管的评估价值。方法收集2014年9月至2015年6月于江苏省徐州医学院附属医院介入放射科首次诊治的40例BCS患者，所有患者均于3．0TMRV检查后1周内行介入治疗。采用Fisher确切概率法检验MRV与数字减影血管造影（DSA）在观察BCS阻塞血管方面的差异，评估3．0TMRV在介入治疗中的指导价值。结果40例患者介入治疗均成功完成。MRV与DSA显示下腔静脉节段性狭窄分别为5例／5例、下腔静脉膜性带孔3例／3例、下腔静脉节段性闭塞25例／24例、肝静脉数量100支／42支、副肝静脉数量21支／7支、下腔静脉伴有血栓6例／5例、下腔静脉闭塞端形态10例／24例、闭塞端伴有危险交通支3例／16例。在观察肝静脉各支、副肝静脉、下腔静脉节段闭塞端形态及危险交通支方面MRV优于DSA（P〈0．05）；在观察下腔静脉节段狭窄、下腔静脉膜型带孔、下腔静脉闭塞及血栓方面两者差异无统计学意义（P〉0．05）。3例患者MRI扫描中发现肝内结节病灶，术中均行肝动脉造影。其中2例诊断BCS合并肝细胞癌，予以肝动脉化疗栓塞术，1例考虑肝硬化再生结节。结论3．0TMRV可为布加综合征的介入治疗提供重要的影像学资料，弥补了DSA造影图像的不足，进一步提高了BCS介入治疗的安全性和有效性。Objective To explore the application of 3.0T magnetic resonance venography （MRV） evaluation on obstructive vessels for interventional therapy in patients with Budd-Chiari syndrome （ BCS ）. Methods From September 2014 to June 2015, 40 consecutive patients with BCS were admitted to our center. These patients received abdominal 3.0T MRV examination, followed by interventional therapy within 1 week. The differences on the vascular obstruction as observed by MRV and digital subtraction angiography （DSA） were compared using the Fisher＇s exact test, and the influence of 3. OT MRV on the interventional therapy was assessed. Results All the 40 patients successfully underwent interventional therapy. 5 and 5 cases of inferior venous cava （IVC） segmental stenosis were shown by MRV and DSA, respectively. 3 and 3 cases of IVC membranous perforation, 25 and 24 cases of IVC segmental obstruction, 100 and 42 branches of hepatic vein, 21 and 7 branches of accessory hepatic vein, 6 and 5 cases of IVC with thrombosis, 10 and 24 cases of IVC with obstruction shape, 3 and 16 cases of IVC with dangerous traffic branch were shown by MRV and DSA, respectively. The differences on the observations of hepatic vein, accessory hepatic vein, shape of IVC segmental obstruction, dangerous traffic branch were statistically significant （ P 〈 0.05 ）. However, there were no significant differences on the IVC segmental stenosis, IVC membranous perforation, IVC segmental obstruction, and IVC with thrombosis between the two methods （ P 〉 O. 05 ）. 3 cases were confirmed to have abnormal liver nodules by MRI and received hepatic arteriography： 2 cases were diagnosed to have hepatocellular carcinoma and received hepatic arterial chemoembolization and 1 case to have a cirrhotic regenerative nodule. Conclusion Before the interventional therapy, valuable imaging information can be provided by 3. OT MRV, which further improved the safety and efficiency of BCS interventional treatment.

关 键 词：布加综合征 磁共振静脉成像 数字减影血管造影 介入治疗 

分 类 号：R743[医药卫生—神经病学与精神病学]