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目的探讨多层螺旋CT(multislice spiral CT,MSCT)在布加综合征(Budd-Chiari syndrome,BCS)中的诊断价值。方法回顾性分析28例经DSA或手术证实的布加综合征MSCT影像特点。结果BCS的MSCT特点为:①CT平扫形态学改变:肝脏不规则增大15例,弥漫增大10例,未见明显改变3例;②强化特征:花斑状强化型11例,周边强化型6例,中央强化型8例,不规则强化3例;③CTA准确显示阻塞的部位及侧支循环血管:肝静脉闭塞3例;下腔静脉狭窄闭塞25例,其中7例伴肝静脉闭塞;显示肝外侧支循环16例,肝内侧支循环2例,肝内外均有侧支循环7例,3例无侧支循环血管。结论MSCT能准确直观反映布加综合征阻塞的性质、部位、范围、侧支血管及其与周围器官的空间关系,能从形态及功能上反映肝脏损害程度。
Objective To investigate the diagnostic value of multislice spiral CT (MSCT) in Budd-Chiari syndrome (BCS). Methods The features of MSCT images of 28 patients with Budd-Chiari syndrome confirmed by DSA or surgery were analyzed retrospectively. Results The MSCT features of BCS were as follows: ①CT morphological changes of CT scan: 15 cases of abnormal hepatic enlargement, 10 cases of diffuse enlargement, no obvious change in 3 cases; ②Early features: 11 cases of focal enhancement, peripheral enhancement 6 3 cases of central venous occlusion, 3 cases of central venous occlusion, 7 cases of inferior vena cava stenosis and occlusion of the hepatic veins, and 6 cases of central strengthening and 3 cases of irregular enhancement. 16 cases of lateral branch, 2 cases of intrahepatic collateral circulation, collateral circulation in 7 cases, 3 cases without collateral vessels. Conclusion MSCT can accurately and directly reflect the nature, location, extent, collateral vessels of the Budd-Chiari syndrome and its spatial relationship with the surrounding organs, and can reflect the degree of liver damage in morphology and function.