Miller W J, Federle M P, Straub W H, Davis P L
Department of Diagnostic Radiology, Presbyterian-University Hospital, Pittsburgh, PA 15213.
Abdom Imaging. 1993 Fall;18(4):329-35. doi: 10.1007/BF00201775.
We retrospectively evaluated 21 patients with Budd-Chiari syndrome who underwent liver transplant. The pathological findings were correlated with imaging studies that included computed tomography (CT) in all cases, sonography in 20, and magnetic resonance (MR) in 15. Pathological features of Budd-Chiari syndrome in subacute or chronic form, such as parenchymal fibrosis, hemorrhage, and congestion, were found in all resected livers. These occurred usually in conjunction with restricted hepatic veins due to thrombosis or fibrosis with partially recanalized lumen. The status of hepatic veins was correctly assessed and correlated with pathology in 13 of 20 patients who had sonograms, in 12 of 15 patients who had MR, and in nine of 18 patients with contrast-enhanced CT scans. Patency of the inferior vena cava was well seen by all three modalities; parenchymal abnormalities were best visible on CT (19 of 21), while ascites, caudate lobe enlargement and collateral vessels were best detected with MR or CT. We conclude that each imaging modality offers certain values and limitations in the assessment of vascular or parenchymal findings in Budd-Chiari syndrome.
我们回顾性评估了21例接受肝移植的布加综合征患者。病理结果与影像学检查结果相关，所有病例均包括计算机断层扫描（CT），20例进行了超声检查，15例进行了磁共振（MR）检查。在所有切除的肝脏中均发现了亚急性或慢性形式的布加综合征的病理特征，如实质纤维化、出血和充血。这些情况通常与肝静脉因血栓形成或纤维化导致管腔部分再通而受限有关。在20例接受超声检查的患者中，有13例、15例接受MR检查的患者中有12例以及18例接受增强CT扫描的患者中有9例，肝静脉的状态得到了正确评估且与病理结果相关。三种检查方式均能很好地显示下腔静脉的通畅情况；实质异常在CT上显示最佳（21例中有19例），而腹水、尾状叶增大和侧支血管在MR或CT上检测最佳。我们得出结论，在评估布加综合征的血管或实质表现时，每种影像学检查方式都有一定的价值和局限性。
