Ueda K, Matsui O, Kadoya M, Yoshikawa J, Gabata T, Kawamori Y, Takashima T
Department of Radiology, Kanazawa University School of Medicine, Kanazawa, Japan.
Abdom Imaging. 1998 May-Jun;23(3):304-8. doi: 10.1007/s002619900346.
To assess the intrahepatic portal flow in patients with Budd-Chiari syndrome (BCS) by computed tomography (CT) during arterial portography (CTAP).
Five patients with BCS [with (n = 3) and without (n = 2) inferior vena cava (IVC) obstruction] underwent both CTAP and postcontrast CT following CTAP. CTAP and postcontrast CT after angioplasty were also performed in one patient. Findings on CTAP and postcontrast CT were analyzed retrospectively.
Patients with IVC obstruction and a patent large hepatic vein showed homogeneous hepatic enhancement on CTAP. Patients without IVC obstruction and with no patent large hepatic veins showed heterogeneous hepatic enhancement, which consisted of patchy enhancement and more definite enhancement in the central part of the liver. On postcontrast CT, the patchy enhancement was enlarged compared with that on CTAP in these patients. The heterogeneous hepatic enhancement became homogeneous in the patient who underwent angioplasty.
We suggest that the more marked the blood congestion, the more heterogeneous the hepatic enhancement becomes on CTAP. Heterogeneous hepatic enhancement on CTAP is seen in such cases without any patent hepatic veins.
通过动脉门静脉造影CT（CTAP）期间的计算机断层扫描（CT）评估布加综合征（BCS）患者的肝内门静脉血流。
5例BCS患者[伴有（n = 3）和不伴有（n = 2）下腔静脉（IVC）阻塞]在CTAP后接受了CTAP和增强CT检查。1例患者在血管成形术后也进行了CTAP和增强CT检查。对CTAP和增强CT的结果进行回顾性分析。
IVC阻塞且肝大静脉通畅的患者在CTAP上显示肝脏均匀强化。无IVC阻塞且无肝大静脉通畅的患者显示肝脏不均匀强化，包括斑片状强化和肝脏中央部分更明显的强化。在增强CT上，这些患者的斑片状强化较CTAP时增大。接受血管成形术的患者肝脏不均匀强化变为均匀强化。
我们认为血液淤血越明显，CTAP上肝脏强化越不均匀。在没有任何肝静脉通畅的情况下，CTAP上可出现肝脏不均匀强化。
