Department of Interventional Radiology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan Province, China.
PLoS One. 2014 Jan 8;9(1):e85135. doi: 10.1371/journal.pone.0085135. eCollection 2014.
To evaluate the type of venous involvement in Chinese Budd-Chiari syndrome (BCS) patients and the relative diagnostic accuracy of the different imaging modalities.
Using digital subtraction angiography (DSA) as a reference standard, color Doppler ultrasound (CDUS), computed tomography angiography (CTA), and magnetic resonance angiography (MRA) were performed on 338 patients with BCS. We analyzed the course of the main and any accessory hepatic veins (HVs) and the inferior vena cava (IVC) to assess the etiology of obstructed segments and diagnostic accuracy of CDUS, CTA and MRA.
Among the 338 cases, there were 8 cases (2.4%) of isolated IVC membranous obstruction, 45 cases (13.3%) of isolated HV occlusion, and 285 cases (84.3%) with both IVC membranous obstruction and HV occlusion. Comparing with DSA, CDUS, CTA had a diagnostic accuracy of 89.3% and 80.2% in detecting BCS, and 83.4% of cases correctly correlated by MRA.
In Henan Province, most patients with BCS have complex lesions combining IVC and HV involvement. The combination of CDUS and CTA or MRI is useful for diagnosis of BCS and guiding therapy.
评估中国布加综合征（BCS）患者静脉受累的类型及不同影像学检查方法的相对诊断准确性。
采用数字减影血管造影（DSA）作为参考标准，对 338 例 BCS 患者进行彩色多普勒超声（CDUS）、计算机断层血管造影（CTA）和磁共振血管造影（MRA）检查。分析主肝静脉和（或）肝静脉属支及下腔静脉（IVC）的走行，评估阻塞节段的病因及 CDUS、CTA 和 MRA 的诊断准确性。
338 例患者中，单纯 IVC 膜性梗阻 8 例（2.4%），单纯 HV 阻塞 45 例（13.3%），IVC 膜性梗阻合并 HV 阻塞 285 例（84.3%）。与 DSA 比较，CDUS、CTA 诊断 BCS 的准确率分别为 89.3%和 80.2%，MRA 正确关联率为 83.4%。
在河南省，BCS 患者以 IVC 和 HV 同时受累的复杂病变为主。CDUS 联合 CTA 或 MRI 有助于诊断 BCS 并指导治疗。
