Vogelzang R L, Anschuetz S L, Gore R M
Radiology. 1987 May;163(2):329-33. doi: 10.1148/radiology.163.2.3562813.
The authors describe four patients with Budd-Chiari syndrome in whom contrast material-enhanced computed tomographic (CT) scans demonstrated low-density venous thrombosis in three sites not, to our knowledge, previously described with this modality. Thrombosis was seen in the portal circulation, the hepatic veins, and the intrahepatic inferior vena cava. It is known that concomitant portal vein thrombosis may be seen in 20% of patients with Budd-Chiari syndrome. Three of the four patients in the current study had this finding, one with extensive thrombosis of portal, mesenteric, and splenic veins and the other two with portal vein branch involvement. In one patient hepatic vein thrombosis was demonstrated with CT, and in three inferior vena cava clot was demonstrated. All four patients had the distinctive hepatic parenchymal contrast enhancement pattern seen in this condition, which the authors think may be at least partially caused by associated portal thrombosis. The presence of portal venous thrombosis should prompt the observer to consider the diagnosis of Budd-Chiari syndrome. Detection of hepatic vein clot confirms the diagnosis and may be seen in this condition in association with inferior vena cava thrombus.
作者描述了4例布-加综合征患者，在这些患者的对比剂增强计算机断层扫描（CT）中显示出低密度静脉血栓形成，据我们所知，有3个部位此前尚未用这种方式描述过。血栓见于门静脉循环、肝静脉和肝内下腔静脉。已知20%的布-加综合征患者可能伴有门静脉血栓形成。本研究的4例患者中有3例有此表现，1例门静脉、肠系膜静脉和脾静脉广泛血栓形成，另外2例门静脉分支受累。1例患者CT显示肝静脉血栓形成，3例显示下腔静脉血栓。所有4例患者均有本病特有的肝实质对比增强模式，作者认为这可能至少部分是由相关门静脉血栓形成所致。门静脉血栓形成的存在应促使观察者考虑布-加综合征的诊断。肝静脉血栓的检测可确诊该病，且在这种情况下可能与下腔静脉血栓同时出现。
