3.0 T MRV辅助DSA介入治疗布加综合征患者效果临床研究

doi:10.3969/j.issn.1672-5069.2020.06.028

摘要/Abstract

摘要： 目的研究3.0 T 磁共振静脉成像(MRV)辅助数字减影血管造影(DSA)下治疗布加综合征(BCS)患者的临床疗效。方法 2014年3月～2019年3月我院收治的120例BCS患者,接受3.0 T MRV检查,并在此成像指导下行DSA下介入治疗。结果 MRV检查下腔静脉闭塞端危险交通支和闭塞端形态显示率分别为7.5%和25.0%,显著低于DSA检查的40.0%和60.0%(P＜0.05),对肝静脉各支(右、中、左)和副肝静脉显示率分别为95.0%、80.0%、75.0%和52.5%,显著高于DSA检查的40.0%、35.0%、30.0%和17.5%(P＜0.05),对下腔静脉节段狭窄、下腔静脉闭塞、下腔静脉膜性带孔和血栓显示率与DSA造影比较差异均无统计学意义(P＞0.05);120例患者经介入治疗均获得成功,其中21例(17.5%)经股静脉入路,63例(52.5%)经右股静脉和右颈内静脉双向入路,3例(2.5%)经皮肝穿刺肝静脉联合颈内静脉双入路,33例(27.5%)经右颈内静脉入路。结论采用3.0 T MRV检查能清晰地显示BCS患者血管阻塞情况,弥补DSA造影的不足,对介入诊疗有很大的辅助作用。

关键词: 布加综合征, 磁共振静脉成像, 数字减影血管造影, 介入治疗

Abstract: Objective The aim of this study was to investigate the auxiliary assistance of MR venography (MRV) for digital subtraction angiography (DSA)-guided interventional therapy in the treatment of patients with Budd-Chiari syndrome(BCS). Methods 120 patients with BCS were admitted to our hospital between March 2014 and March 2019, and underwent 3.0 T MRV. All patients received interventional therapy under DSA guidance. Results The MRV showed 7.5% and 25.0% of the dangerous communicating branches and occlusive ends of inferior vena cava, significantly lower than 40.0% and 60.0% by DSA (P<0.05), and 95.0%, 80.0%, 75.0% and 52.5% of right, middle and left branches of hepatic vein, and accessory hepatic vein, respectively, all significantly higher than 40.0%, 35.0%, 30.0% and 17.5% by DSA (P<0.05), while there were no significant differences as for the demonstration of segment of inferior vena cava, stenosis, inferior vena cava occlusion, inferior vena cava membranous formation and thrombosis by the two methods (P>0.05); the interventional therapy was successful in 120 patients, for which, 21 cases (17.5%) by via femoral vein, 63 cases (52.5%) via right femoral veinand right internal jugular vein, 3 cases (2.5%) via percutaneous hepatic vein combined with internal jugular vein, and 33 cases (27.5%) via right internal jugular vein. Conclusion The MRV could clearly show the obstruction of blood vessels in patients with Budd-Chiari syndrome before interventional therapy, which might help the correct operation under DSA angiography in clinical practice.

Key words: Budd-Chiari syndrome, Magnetic resonance venography, Digital subtraction angiography, Interventional therapy

程影, 陈育锋, 祁良. 3.0 T MRV辅助DSA介入治疗布加综合征患者效果临床研究[J]. 实用肝脏病杂志, 2020, 23(6): 869-872.

Cheng Ying, Chen Yufeng, Qi Liang. Auxiliary assistance of MR venography for DSA-guided interventional therapy in the treatment of patients with Budd-Chiari syndrome[J]. Journal of Practical Hepatology, 2020, 23(6): 869-872.

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