Abstract: Objective To study the diagnostic value of three-dimensional reconstruction of blood vessels in differential diagnosis of patients with Budd-Chiari syndrome (BCS) and liver cirrhosis after hepatitis B infecton. Methods 28 patients with BCS and 46 patients with liver cirrhosis after hepatitis B viral infection were enrolled between March 2017 and March 2020, and All patients underwent three-dimensional reconstruction of blood vessels by CT imaging. The imaging features of three-dimensional reconstruction of blood vessels were recorded. The Logistic regression analysis was applied to explore the value of each sign in the diagnosis of BCS, and a regression equation was established. The receiver operating characteristic curve (ROC) was used to analyze the value of this regression equation in the diagnosis of BCS. Results The collateral opening of intrahepatic vein in patients with BCS was 82.1%, which was significantly higher than that in patients with cirrhosis(15.2%, P<0.05), the communication between azygos vein and ascending lumbar vein was 46.4%, which was significantly higher than that in cirrhosis group (10.9%, P<0.05), the filling defects of inferior vena cava and hepatic vein in BCS group were 85.7% and 92.9%, respectively, which were significantly higher than those in cirrhosis group (10.9% and 8.7%,P<0.05), the retroperitoneal varicosity in BCS group were 35.7%, which was significantly higher than that in cirrhosis group (10.9%,P<0.05), the caudate lobe enlargement in BCS group was 64.3%, which was significantly higher than that in cirrhosisgroup (6.5%,P<0.05), the map snow pattern enhancement was 82.1% in BCS group, which was significantly higher than in the cirrhosis group(6.5%,P<0.05), the uneven enhancement of portal phase in BCS group was 85.7%, which was significantly higher than that in cirrhosis group (13.0%,P<0.05); the multivariate Logistic analysis showed that the collateral opening of intrahepatic vein (95%CI=1.035-3.332,P=0.038), the communication between azygos vein and ascending lumbar vein (95%CI=1.203-2.296,P=0.002), the filling defect of inferior vena cava (95% CI=1.694-4.893,P=0.000),the filling defect of hepatic vein (95%CI=1.695-3.156,P=0.000),the caudate lobe enlargement (95%CI=1.012-1.901, P=0.042), and the uneven enhancement of portal phase (95%CI=1.234-2.916,P=0.004) were the independent indicator in the diagnosis of BCS; the regression equation was established,and the ROC analysis showed that the AUC of the regression equation we established in diagnosis of BCS was 0.888 (95%CI=0.812～0.965,P=0.000), which were highest among any other signs. Conclusion The three dimensional reconstruction of blood vessels by CT scan is helpful to distinguish between BCS and the hepatitis B liver cirrhosis, which might be used for early screening and diagnosis of patients with BCS.

Key words: Budd-Chiari syndrome, Liver cirrhosis, Three dimensional reconstruction of blood vessels, Diagnosis