非增强磁共振下腔静脉成像对布加综合征的诊断价值

发布时间：2018-07-16 13:49

【摘要】：目的探讨非增强MR血管成像(NCE-MRV)在布加综合征(BCS)诊断中的应用价值。资料与方法 35例怀疑BCS患者均行NCE-MRV和数字减影血管造影(DSA)检查,比较两者的一致性,并计算NCE-MRV的诊断敏感度、特异度、准确度、阴性预测值及阳性预测值。结果 35例患者中,32例DSA诊断为BCS,33例NCE-MRV诊断为BCS,DSA显示下腔静脉膜性狭窄8例(NCE-MRV10例),膜性阻塞7例(NCE-MRV 6例),节段性狭窄3例(NCE-MRV 4例),节段性阻塞10例(NCE-MRV 10例),下腔静脉血栓5例(NCE-MRV 5例)。NCEMRV诊断BCS的敏感度为100.0%,特异度为67.8%,准确度为97.1%,阴性预测值为100.0%,阳性预测值为96.9%。NCE-MRV与DSA相比较具有良好的一致性(Kappa=0.89)。NCE-MRV显示肝内侧支血管30例,肝外侧支血管27例,副肝静脉25例。结论 NCE-MRV对于BCS下腔静脉病变的诊断与DSA对比有良好的一致性,可以作为BCS可疑患者诊断下腔静脉阻塞的无创检查手段。
[Abstract]:Objective to evaluate the value of non-contrast-enhanced Mr angiography (NCE-MRV) in the diagnosis of Budd Chiari syndrome (BCS). Materials and methods 35 patients with suspected BCS were examined by NCE-MRV and digital subtraction angiography (DSA). The diagnostic sensitivity, specificity, accuracy, negative predictive value and positive predictive value of NCE-MRV were calculated. Results among the 35 cases, 32 cases were diagnosed as BCS-MRV in 33 cases with NCE-MRV, 8 cases with membranous stenosis of inferior vena cava (NCE-MRV 10 cases), 7 cases with membranous obstruction (NCE-MRV 6 cases), 3 cases with segmental stenosis (NCE-MRV 4 cases), 10 cases with segmental obstruction (NCE-MRV 10 cases) and 10 cases with inferior cavity obstruction. The sensitivity, specificity, accuracy, negative predictive value and positive predictive value of venous thrombosis were 100.0g, 67.8, 97.1and 100.0.The positive predictive value was 96.9. NCE-MRV was consistent with DSA (Kappa 0.89) .NCE-MRV showed medial hepatic vessels in 30 cases. There were 27 cases of collateral vessels and 25 cases of accessory hepatic veins. Conclusion NCE-MRV is in good agreement with DSA in the diagnosis of inferior vena cava lesions, and it can be used as a noninvasive method in the diagnosis of inferior vena cava obstruction in patients with suspected BCS.
【作者单位】：河南省人民医院放射科;GE医疗公司;郑州大学第一附属医院介入科;
【基金】：国家临床重点专科建设项目
【分类号】：R575;R445.2

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