摘要
目的探讨肝静脉阻塞型布-加综合征(HVBCS)临床症状、影像学特征及误治分析。方法13例误治的HVBCS患者,5例行下腔静脉球囊扩张术,8例行下腔静脉支架植入。分析13例患者临床症状、体征及影像学资料,经DSA造影进一步证实后予肝静脉成形术。结果所有患者均有不同程度的门静脉高压表现,无明显下腔静脉阻塞症状。CT或(和)MRI示肝尾状叶明显增大,DSA示下腔静脉呈外压性狭窄。13例均成功实施肝静脉成形术;其中4例行单纯PTA,9例行PTA+支架,术后所有患者临床症状与体征完全消失或明显改善。结论HVBCS的下腔静脉狭窄不是其本身病变,而是肝尾状叶代偿性增大压迫所致。肝静脉成形术是一种正确的、安全、有效的治疗方法。
Objective To investigate the clinical symptoms and imaging features of Budd-Chiari syndrome with hepatic vein obstruction （HVBCS） and the reasons of mistreatment. Methods Thirteen patients with HVBCS were misdiagnosed and mistreated as inferior vena cava （IVC） obstruction, including 8 patients treated with stent implantation in IVC once and 5 patients with balloon dilatation. After analysis of the clinical symptoms, signs and imaging features; hepatic vein obstruction was further confirmed by digital subtraction angiography （DSA）in all patients. Results All patients had variable degrees of portal hypertension and no apparent symptoms of IVC obstruction. CT or/and MRI showed obvious caudate lobe enlargement and DSA showed IVC narrowing with external compression. All patients were undertaken hepatic vein angiography including 4 with PTV and 9 with hepatic vein stent implantation. All patients＂ clinical symptoms and signs completely disappeared or markedly improved after the procedure. Conclusion The stenosis of IVC in HVBCS, caused by compression compensatory hypertrophy of hepatic caudate lobe can be cured by hepatic vein angioplasty which is the most correct and effective method.
出处
《介入放射学杂志》
CSCD
2008年第11期769-772,共4页
Journal of Interventional Radiology
