Erden Ayşe
Ankara University, School of Medicine, Department of Radiology, Talatpaşa Bulvari, Sihhiye 06100, Ankara, Turkey.
Eur J Radiol. 2007 Jan;61(1):44-56. doi: 10.1016/j.ejrad.2006.11.004. Epub 2006 Nov 22.
Budd-Chiari syndrome is an uncommon, often fatal disorder resulting from an obstructed hepatic venous outflow tract. The obstructive lesion is situated in the main hepatic veins, in the inferior vena cava or in both. The nature, location and extension of the obstruction can be displayed on diagnostic imaging techniques. In addition to this direct evidence, the indirect findings of venous obstruction such as the presence of intra- and extrahepatic collateral veins, when combined with the altered morphology and enhancement pattern of the liver enables one to arrive at a confident diagnosis. In patients with suspected Budd-Chiari syndrome, gray-scale sonography with complementary support of color and pulsed Doppler examinations is the first step in approaching the diagnosis. It is followed by a contrast-enhanced cross-sectional technique, preferrentially by MR angiography. The patients with a high clinical suspicion of Budd-Chiari syndrome may undergo hepatic venography or venacavography directly so that a potential of recanalization (e.g. percutaneous transluminal angioplasty with or without stent placement or TIPS) of the obstructed segment under the guidance of these techniques would not be delayed.
布加综合征是一种罕见的、通常致命的疾病，由肝静脉流出道阻塞引起。阻塞性病变位于肝主静脉、下腔静脉或两者均有。阻塞的性质、位置和范围可通过诊断成像技术显示。除了这些直接证据外，静脉阻塞的间接表现，如肝内和肝外侧支静脉的存在，与肝脏形态和强化方式的改变相结合，有助于做出可靠的诊断。对于疑似布加综合征的患者，首先进行灰阶超声检查，并辅以彩色和脉冲多普勒检查以辅助诊断。接下来是对比增强横断面技术，优先选择磁共振血管造影。临床高度怀疑布加综合征的患者可直接进行肝静脉造影或腔静脉造影，以免在这些技术的引导下延迟对阻塞段进行再通（如经皮腔内血管成形术，可带或不带支架置入或经颈静脉肝内门体分流术）的可能性。
