ABSTRACT
Objective To explore a compatible approach to detect and classify the lesions of inferior vena cavas (IVCs) on sonogram in patients with Budd-Chiari syndrome(BCS).Methods Ultrasonogram of the IVCs were observed detailedly in 300 patients with BCS by using trans-abdomen and trans-thorax-right atrium-inferior vena cava ingress sections.Transducers usually used for heart examination were applied in the latter.Lesions of the IVCs found in 277 out of 300 patients were classified.All lesions were confirmed by digital subtraction angiography (DSA) and among them,52 cases underwent computed tomography angiography (CTA).Results Lesions of IVCs were classified into 3 categories as follows:membranous type,segmental type,and ex-pressed type.① Membranous type (thickness ≤ 15 mm) included membranous stenosis type and membranous occlusion type.On the basis of the thickness,the membranous stenosis type was further classified into thinner membranous stenosis type (thickness ≤5mm) and thicker membranous stenosis type (5 mm＜thickness≤ 15 mm).The membranous occlusion type was further classified into thinner membranous occlusion type (thickness ≤5 mm) and thicker membranous occlusion type (5 mm＜thickness ≤15 mm).② Segmental type (lengtb ＞ 15 mm) was consist of segmental stenosis type and segmental occlusion type.Based on the length of the lesion,the segmental stenosis type was further divided into longer segmental stenosis type (length ＞ 30 mm) and shorter segmental stenosis type (15 mm＜length ≤30 mm).The segmental occlusion type was further divided into longer segmental occlusion type (length ＞ 20mm) and shorter segmental occlusion type (15 mm＜ length ≤20 mm).③ Ex-pressed type of IVCs was mainly caused by compression of intumescent caudate lobes.Corresponding sonographic features were demonstrated in each type.Conclusions Ultrasonogram of trans-abdomen and trans-thorax-right atrium-inferior vena cava ingress sections could accurately classify the lesions of IVCs.It is of important significance for the clinical treatment.
ABSTRACT
Objective To summarize sonographic classification of blood-drainage in Budd-Chiari syndrome (BCS)with hepatic vein(HV)obstruction in order to provide much information for clinical treatment.Methods A total of 185 patients with HV obstruction were underwent sonographic examination.The affection of HV,the courses,orifices,blood flow direction of drainage viens,the communicating branches among HVs and draining viens were observed detailedly.Classification of blood-drainage pattern were performed by sonogram in accordance with digital subtraction angiography(DSA)and computed tomography angiography(CTA).Results There were 490 HVs with affection in 185 patients.The blood drainage pattern were classified as the following six types:HV-accessory HV(AHV)type(119/185),HV-HV type(31/185),HV-AHV/HV type(14/185),inferior caval vein (IVC)-AHV-HV-right atrium type(9/185),HV-umbilical vein type(5/185)and HV-hepatic subeapsular vein type (7/185).Blood of obstructed HVs was drainaged to IVC,right atrium,umbilical veins or hepatic subcapsular veins through communicating branches which were in various amount and diameter.Haemodynamics was obtained from drainage veins correspondingly.Conclusions Sonographic classification of blood-drainage pattern in BCS with hepatic vein obstruction is of important clinical significance in the treatment.
ABSTRACT
Objective To study the ultrasonic features of the congenital vaginal reclined septum syndrome (CVRS) in order to apply a precise way for operations. Methods To diagnose CVRS accurately before operation, the ultrasonogram and clinical characteristics of 15 cases were studied retrospectively. Results There were duplicated uterus and cervices with ipsilateral renal agenesis on the reclined septum side in all the patients,11 in the right and 4 in the left. All of 10 cases of type Ⅰhad been made final diagnosis before operation according to the specific ultrasonogram and the rest of type Ⅱ and type Ⅲ had been made reliable diagnosis. Conclusions Ultrasonic examination should be the first way to diagnose CVRS.