肝窦阻塞综合征与布加综合征的MRI征象比较  

Comparison of MRI Features of Hepatic Sinusoidal Obstruction Syndrome and Budd-Chiari Syndrome

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作  者:马彩丽 杨正汉[1] 杨大为[1] MA Caili;YANG Zhenghan;YANG Dawei(Department of Radiology,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区:[1]首都医科大学附属北京友谊医院放射科,北京100050 [2]北京市隆福医院放射科,北京100010

出  处:《中国医学影像学杂志》2025年第3期298-303,共6页Chinese Journal of Medical Imaging

基  金:国家自然科学基金(82372043)。

摘  要:目的对比分析肝窦阻塞综合征(HSOS)与布加综合征(BCS)的MRI征象。资料与方法回顾性收集2016年4月—2023年11月首都医科大学附属北京友谊医院经肝脏穿刺活检或临床诊断的12例HSOS及肝脏穿刺活检或肝移植病肝病理或数字减影血管造影诊断的12例BCS患者,分析两者的临床及MRI征象,总结特征性征象。结果HSOS患者谷草转氨酶、总胆红素、直接胆红素较BCS高,白蛋白较BCS低,差异有统计学意义(Z=-3.407、-2.078、-2.425、-2.252,P均<0.05)。12例HSOS中,10例有服用土三七中药史,6例第二肝门特征性三叶草样强化,BCS无此征象。12例BCS中,10例门静脉主干增宽,10例脾大,10例副肝静脉,8例肝横静脉,11例肝周侧支,7例椎旁静脉曲张。HSOS、BCS患者MRI平扫肝实质信号不均分别为12例、10例,门静脉期及延迟期肝实质信号花斑样强化分别为12例、12例。结论特征性MRI征象有助于诊断HSOS和BCS,结合是否服用土三七中药史有助于两者鉴别。Purpose To compare the MRI features of hepatic sinusoidal obstruction syndrome(HSOS)and Budd-Chiari syndrome(BCS).Materials and Methods A total of 12 cases of HSOS and 12 cases of BCS diagnosed with liver biopsy or liver transplantation disease or digital subtraction angiography were retrospectively collected from April 2016 to November 2023 in Beijing Friendship Hospital,Capital Medical University.The clinical and MRI features of the two groups were analyzed,and the characteristic clinical and MRI features were summarized.Results The glutamic-oxaloacetic transaminase,total bilirubin and direct bilirubin in HSOS patients were significantly higher than those in BCS group,while albumin was significantly lower than that in BCS group,the difference was statistically significant(Z=-3.407,-2.078,-2.425,-2.252,all P<0.05).Of the 12 HSOS patients,ten patients with HSOS had a history of taking hebel medicine(gynura segetum),six patients with HSOS showed the second portal of liver characteristic trifolium-like enhancement,BCS features did not appear.Of the 12 BCS patients,ten had main portal vein widening,ten spleen enlargement,ten accessory hepatic vein,eight transverse hepatic vein,eleven perihepatic lateral branch and seven paravertebral varicose veins.In HSOS and BCS patients,the uneven proportion of liver parenchymal signals was identified by MRI plain scan(12 cases,10 cases,respectively),and the proportion of liver parenchymal signal mottle-like enhancement was also demonstrated in portal and delayed phases(12 cases,12 cases,respectively).Conclusion The characteristic MRI signs are helpful for the diagnosis of HSOS and BCS,and the history of taking hebel medicine(gynura segetum)is helpful for the differentiation of the two diseases.

关 键 词:肝窦阻塞综合征 巴德-吉亚利综合征 磁共振成像 诊断 鉴别 病理学 外科 

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]

 

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