Application of CT venography imaging in the diagnosis of Budd-Chiari syndrome
Shi Biao1, Chen Shiyuan2, Wang Xiaogao2, Gao Yong2, Wei Jianzhu3, Qiao Xiaochun1, Ge Jiankang4, Li Wenming4
1Department of Medical Imaging, Bengbu First People's Hospital, Bengbu 233000, China; 2Department of Vascular Surgery, the First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, China; 3Department of Interventional Radiology, the First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, China; 4Department of General Surgery, Guangde People's Hospital, Guangde 242200, China
Abstract：Objective This paper discusses the application value of CT venography (CTV) in the preoperative diagnosis of Budd-Chiari syndrome (BCS). Methods A total of 136 patients with BCS, 78 males and 58 females aged 24-82, were included in a retrospective study conducted in the First People's Hospital of Bengbu and the First Affiliated Hospital of Bengbu Medical College from May 2017 to November 2021. The patients were examined with CTV and digital subtraction angiography (DSA), and the three-dimensional structures of the inferior vena cava, hepatic vein, and collateral vessels were reconstructed and analyzed. The following items were observed: (1) The CTV imaging findings of the patients; (2) Differences between CTV and DSA in assessing and diagnosing obstructed vessels, BCS complicated with thrombus, and liver cancer. Results (1) The CTV imaging findings were as follows: liver cirrhosis, splenomegaly, ascites, and significantly enlarged caudate lobe; in the early stage of enhancement, the caudate lobe and the central part of the left hepatic lobe was rapidly enhanced, and the liver parenchyma showed patchy heterogeneous enhancement (central fan-like enhancement), the density of delayed enhancement tended to be uniform, and the formation of collateral circulation is visible.(2) There were no significant differences between CTV and DSA in the diagnosis of segmatic hepatic vein occlusion, membranous hepatic vein occlusion, extensive hepatic vein occlusion, segmatic inferior vena cava occlusion, membranous inferior vena cava occlusion, membranous perforated inferior vena cava occlusion, hepatic vein occlusion and inferior vena cava occlusion (χ2= 0.13, 0.00, 0.00, 0.44, 0.13, 0.25, 0.80; all P values >0.05). The proportion of liver cancer diagnosed with CTV was higher than that with DSA (5 vs. 0), and the difference was statistically significant (χ2=4.00, P=0.046). There was no significant difference in the diagnosis of BCS complicated with thrombosis between CTV and DSA. Conclusions CTV technology can accurately display the vascular lesions of patients with BCS. Its accuracy is comparable to that of DSA but is higher in the diagnosis of combined liver cancer. Hence, CTV can facilitate the preoperative diagnosis of BCS and the formulation of clinical treatment options.
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Shi Biao, Chen Shiyuan, Wang Xiaogao, Gao Yong, Wei Jianzhu, Qiao Xiaochun, Ge Jiankang, Li Wenming. Application of CT venography imaging in the diagnosis of Budd-Chiari syndrome. Chinese Journal of Anatomy and Clinics, 2022, 27(11): 758-762.
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2022, Vol. 27 
