Dong J T, Huang M J, Kao P F
Taiwan Yi Xue Hui Za Zhi. 1989 Aug;88(8):843-6, 842.
To evaluate the diagnostic value of radionuclide inferior veno-cavagraphy (RIVC) for Budd-Chiari Syndrome, RIVC using Tc99m was performed on 106 patients with massive ascites. A positive RIVC result was defined as having at least two of the three following criteria: (1) a delay of more than 4 seconds in visualizing the heart; (2) sharply truncated inferior vena cava with marked hang-up of isotope activity; and (3) extensive collateral circulation. Of the 106 patients, 18 were RIVC positive and were later confirmed by operation or contrast venography to have Budd-Chiari Syndrome with IVC obstruction. Of the remaining 88 RIVC negative patients, 3 were shown by operation, computerized tomography and cardiac echo, respectively, to be Budd-Chiari Syndrome with IVC obstruction. Thus, the diagnostic sensitivity and specificity of RIVC for this syndrome was 85.7% and 100% respectively. If RIVC is combined with hepatic scintigraphy, it will help to elucidate the anatomic and functional change of IVC, as well as, liver parenchymal disease, such as liver cirrhosis, hepatic tumor or hepatic vein obstruction. RIVC is a simple safe, accurate, noninvasive and reproducible procedure. This study confirms the high diagnostic specificity and sensitivity of RIVC. We therefore recommend RIVC as the first-line study for IVC patency. Contrast venography may be used as a confirmatory study in preparation for surgical intervention.
为评估放射性核素下腔静脉造影术（RIVC）对布加综合征的诊断价值，对106例大量腹水患者进行了使用锝99m的RIVC检查。RIVC结果阳性定义为符合以下三项标准中的至少两项：（1）心脏显影延迟超过4秒；（2）下腔静脉明显截断且同位素活性明显滞留；（3）广泛的侧支循环。106例患者中，18例RIVC阳性，随后经手术或静脉造影证实患有布加综合征伴下腔静脉阻塞。其余88例RIVC阴性患者中，分别有3例经手术、计算机断层扫描和心脏超声检查显示患有布加综合征伴下腔静脉阻塞。因此，RIVC对该综合征的诊断敏感性和特异性分别为85.7%和100%。如果将RIVC与肝脏闪烁扫描相结合，将有助于阐明下腔静脉的解剖和功能变化，以及肝实质疾病，如肝硬化、肝肿瘤或肝静脉阻塞。RIVC是一种简单、安全、准确、无创且可重复的检查方法。本研究证实了RIVC具有较高的诊断特异性和敏感性。因此，我们推荐将RIVC作为评估下腔静脉通畅性的一线检查方法。静脉造影可作为手术干预前的确诊检查。
