Clinical significance of multislice spiral CT scans in hepatic veins occlusion in Budd-Chiari syndrome / 中华医学杂志(英文版)
Chinese Medical Journal
;
(24): 100-105, 2007.
Artigo
em Inglês
| WPRIM
| ID: wpr-273329
ABSTRACT
<p><b>BACKGROUND</b>Budd-Chiari syndrome with hepatic vein occlusion (HVBCS) can induce severe portal hypertension and liver damage. We retrospectively analyzed hepatic CT features of HVBCS and evaluated the usefulness of triphasic enhancement of CT examinations and CT angiography (CTA) in its diagnosis.</p><p><b>METHODS</b>Twenty-five cases with HVBCS, confirmed by digital subtraction angiography (DSA), received a triphasic enhancement CT scan within one week before DSA. The CTA images of the relevant blood vessels were reconstructed with maximum intensity projection, volume rendering and oblique reformat techniques.</p><p><b>RESULTS</b>Compared with DSA, the detection rate of transverse CT and CTA images for abnormal hepatic vein were 81.7% (58/71) and 95.8% (68/71) (chi(2) = 7.044, P = 0.008), for membranous obstruction were 47.4% (9/19) and 84.2% (16/19) respectively (chi(2) = 5.729, P = 0.017), for segmental obstruction were 88.0% (22/25) and 100% (25/25) respectively (chi(2) = 1.418, P = 0.234). The detection rates for hepatic vein stenosis were 100% with each method. Diffuse hepatomegaly was found in all 6 cases in acute phase and 3 of 19 cases in chronic phase who had severe obstruction of three hepatic veins without patent intrahepatic collaterals. The other 16 cases in chronic phase had hepatatrophia to different extents related to the obstructed hepatic vein. All in acute phase and 15 in chronic phase presented typical patchy enhancement initially in caudate lobe and perihilar areas and enlarged with time delay. In all cases, parenchyma areas with atrophy, necrosis and congestion demonstrated lower and later enhancement. In all the parts, which had normal enhancement at least one patent outflow hepatic vein, accessory hepatic vein or collateral vessel was detected.</p><p><b>CONCLUSION</b>Dynamic enhancement CT examination by multislice spiral CT not only could improve the diagnosis of HVBCS by CTA technique, but also could noninvasively provide anatomical information and reveal damage to the hepatic parenchyma.</p>
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Diagnóstico por Imagem
/
Angiografia Digital
/
Estudos Retrospectivos
/
Tomografia Computadorizada Espiral
/
Síndrome de Budd-Chiari
/
Métodos
Tipo de estudo:
Estudo diagnóstico
/
Estudo observacional
Limite:
Adulto
/
Feminino
/
Humanos
/
Masculino
Idioma:
Inglês
Revista:
Chinese Medical Journal
Ano de publicação:
2007
Tipo de documento:
Artigo
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