CAJ | 학술논문

目的探讨磁共振成像(MRI)联合3D-CE-MRA在布-加综合征中的诊断价值.方法回顾性分析经手术治疗的布-加综合征惠者资料14例,术前均经MRI常规检查及三期增强扫描并行3D-CE-MRA重建,复习布-加综合征在MRI及3D-CE-MRA上的影像学表现并和手术作对照.结果 14例中,单纯肝后段下腔静脉狭窄2例,单纯主肝静脉狭窄1例,肝后段下腔静脉合并主肝静脉狭窄11例,肝内侧支循环11例,肝外侧支循环10例,门静脉扩张5例,肝脏增大12例,其内信号不均匀,尾状叶增大9例,脾脏增大5例,腹水3例.膜性狭窄5例,阶段性狭窄9例.先天性狭窄或阻塞7例,血栓引起狭窄1例,肿瘤受侵及血管内癌栓3例,肿瘤受压1例,血肿受压1例.MRI对14例布-加综合征的定位、分型及周围结构关系与手术所见一致,其准确性、敏感性及特异性均达到100%.MRI反映肝硬化的各种信号特点与病理相近.结论 MRI联合3D-CE-MRA能够显示布-加综合征的各种征象,并能做出正确的诊断和分型,能够鉴别和区分引起布-加综合征的确切病因.
목적 탐토자공진성상(MRI)연합3D-CE-MRA재포-가종합정중적진단개치.방법 회고성분석경수술치료적포-가종합정혜자자료14례,술전균경MRI상규검사급삼기증강소묘병행3D-CE-MRA중건,복습포-가종합정재MRI급3D-CE-MRA상적영상학표현병화수술작대조.결과 14례중,단순간후단하강정맥협착2례,단순주간정맥협착1례,간후단하강정맥합병주간정맥협착11례,간내측지순배11례,간외측지순배10례,문정맥확장5례,간장증대12례,기내신호불균균,미상협증대9례,비장증대5례,복수3례.막성협착5례,계단성협착9례.선천성협착혹조새7례,혈전인기협착1례,종류수침급혈관내암전3례,종류수압1례,혈종수압1례.MRI대14례포-가종합정적정위、분형급주위결구관계여수술소견일치,기준학성、민감성급특이성균체도100%.MRI반영간경화적각충신호특점여병리상근.결론 MRI연합3D-CE-MRA능구현시포-가종합정적각충정상,병능주출정학적진단화분형,능구감별화구분인기포-가종합정적학절병인.
Objective To explore the value of diagnosis of MR imaging combined with 3D - CE - MRA in Budd - Chiari syndrome (BCS). Methods The data of 14 cases with BCS who were operated were analyzed retrospectively,which were all per-formed with MR imaging routing scan and three - phase enhanced scans with 3D - CE - MRA rebuilding,then to review MRI and3D - Cs. Simple stenosis of inferior vena cave (IVC) after the level of bepar occurred in 2 cases, simple stenosis of main hepatic venous (HV) in 1 case, stenosis of IVC complicating stenosis of main HV in 11 cases, collateral circulation of inner - hepar in 11 cases, collateral circulation of outer - hepar in 10 cases, dilat of portal vein in 5 cases, hepatauxe in 12 cases which presented unequal signal, megaly of candate lobe in 9 cases, splenomegaly in 5 cases and hydroporitoneum in 3 cases. Membranous stenosis of IVC occurred in 5 cases and segmental stenosis of IVC in 9 cases. Congenital stenosis or obstruction of IVC occurred in 7 cases and stenosis of IVC caused by thrombus occurred in 1 case, which caused by intravaseular carcinoembolus invaded by tumor occurred in 3 cases, caused by compression of tumor in 1 case and caused by compression of haematoma in 1 case. Location, typing and surroundingstructural relationship of Budd - Chiari syndrome of 14 cases were coincident between MR imaging findings and operating findings with 100 percent of accurate. MR imaging of hepatic cirrhosis could display a series of signal character coinciding with operating and pathologic findings. Conclusion MR imaging combined with 3D - CE - MRA can discover kinds of signs of BCS,whieh are helpful for correctly making diagnosis and typing and can identify and distinguish exact factors causing to BCS.