Noone T C, Semelka R C, Woosley J T, Pisano E D
Department of Radiology, University of North Carolina Hospitals, Chapel Hill 27599-7510, USA.
J Comput Assist Tomogr. 1996 Sep-Oct;20(5):819-22. doi: 10.1097/00004728-199609000-00029.
This report describes the sonographic and MR appearances of acute Budd-Chiari syndrome (BCS) in a 30-year-old woman. Current imaging techniques including duplex Doppler sonography and dynamic gadolinium-enhanced MRI were employed, and direct histopathologic correlation was made. Duplex Doppler sonography revealed a heterogeneous enlarged liver, no flow in the left and middle hepatic veins, and only trace abnormal flow in the distal-most right hepatic vein. Dynamic serial gadolinium-enhanced, spoiled gradient echo imaging demonstrated early homogeneous enhancement of an enlarged caudate lobe, as well as heterogeneously decreased enhancement of the remainder of the hepatic parenchyma. This differential enhancement pattern persisted on delayed imaging. Patent hepatic veins were not demonstrated on any sequence. Associated findings included hepatomegaly, ascites, and patent portal vasculature. These imaging findings were interpreted as consistent with acute BCS. Within 10 days, the patient underwent orthotopic liver transplantation. Histopathology demonstrated hepatic necrosis and hepatic venous thrombosis consistent with acute BCS.
本报告描述了一名30岁女性急性布加综合征（BCS）的超声和磁共振成像表现。采用了包括双功多普勒超声和动态钆增强磁共振成像在内的当前成像技术，并进行了直接组织病理学对照。双功多普勒超声显示肝脏肿大且回声不均匀，肝左静脉和肝中静脉无血流信号，仅在肝右静脉最远端有微量异常血流信号。动态系列钆增强扰相梯度回波成像显示，肿大的尾状叶早期呈均匀强化，而肝实质其余部分强化不均匀减低。这种强化差异模式在延迟成像时持续存在。在任何序列上均未显示肝静脉通畅。相关表现包括肝肿大、腹水和门静脉血管系统通畅。这些影像学表现被解释为符合急性BCS。10天内，患者接受了原位肝移植。组织病理学显示肝坏死和肝静脉血栓形成，符合急性BCS。
