Department of Interventional Radiology, Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Beijing 100853, China.
BMC Gastroenterol. 2013 Jun 24;13:105. doi: 10.1186/1471-230X-13-105.
Budd-Chiari syndrome (BCS) often leads to hepatocellular carcinoma (HCC). Transcatheter arterial chemoembolization (TACE) has been increasingly used to treat BCS patients with HCC. The purposes of this study were to illustrate imaging features in BCS patients with HCC, and to analyze the effects of TACE on BCS patients with HCC.
246 consecutive patients with primary BCS were retrospectively studied. 14 BCS patients with HCC were included in this study. BCS were treated with angioplasty and/or stenting, and HCC were managed with TACE. Imaging features on ultrasonography, CT, MRI, and angiography and the serum AFP level were analyzed.
Inferior vena cava block and stricture of hepatic venous outflow tract more frequently occurred. Portal vein invasion was found in only 2 patients (14.2%). Imaging studies showed that most nodules of HCC were near the edge of liver, irregular, more than 3 cm in diameter, heterogeneous mass and solitary (≤3 nodules). HCC in patients associated with BCS was isointense or hypointense in nonenhanced CT images, and exhibited heterogeneous enhancement during the arterial phase and washout during the portal venous phase on enhanced CT and MRI. The serum AFP level significantly declined after TACE treatment.
BCS patients with inferior vena cava block and stricture of hepatic venous outflow tract seems to be associated with HCC. A single, large, irregular nodule with a peripheral location appears to be HCC. TACE can effectively treat HCC in BCS patients.
布加综合征（BCS）常导致肝细胞癌（HCC）。经导管动脉化疗栓塞（TACE）已越来越多地用于治疗合并 HCC 的 BCS 患者。本研究旨在阐述合并 HCC 的 BCS 患者的影像学特征，并分析 TACE 对合并 HCC 的 BCS 患者的疗效。
回顾性分析 246 例原发性 BCS 患者，其中 14 例 BCS 合并 HCC 患者纳入本研究。BCS 患者接受血管成形术和/或支架置入治疗，HCC 患者接受 TACE 治疗。分析超声、CT、MRI 和血管造影的影像学特征及血清 AFP 水平。
下腔静脉阻塞和肝静脉流出道狭窄更为常见。仅 2 例（14.2%）患者存在门静脉侵犯。影像学研究显示，HCC 结节多位于肝脏边缘，形态不规则，直径＞3cm，呈混杂密度，单发（≤3 个结节）。与 BCS 相关的 HCC 在平扫 CT 上呈等或稍低信号，增强 CT 和 MRI 动脉期呈不均匀强化，门静脉期呈洗脱。TACE 治疗后血清 AFP 水平显著下降。
下腔静脉阻塞和肝静脉流出道狭窄的 BCS 患者似乎与 HCC 相关。单发、大、形态不规则、边缘分布的结节提示 HCC。TACE 可有效治疗 BCS 合并 HCC 患者。
