【摘要】 目的:评价BCS行下腔静脉造影中见到的一种征象用于诊断肝静脉口部膜性阻塞及指导穿刺破膜。资料与方法:对17例拟珍BCS的病人做了下腔静脉造影,其中5例诊断肝静脉膜性阻塞者经颈静脉或股静脉,用下腔静脉造影所示“乳头征”或结合术中超声引导穿刺针破膜,行肝静脉测压、造影及球囊扩张。结果:5例肝静脉膜性阻塞下腔静脉造影都见到壁向腔内的结节状充盈缺损。经腔静脉穿刺破膜均获成功。肝静脉造影证实口部膜性阻塞。球囊扩张后重建了肝静脉流出道,肝静脉压平均下降1.84kPa。结论:下腔静脉造影显示的壁向腔内结节状突起提示肝静脉口部膜性阻塞。此征象可作为穿刺标记开通肝静脉。更多还原

【Abstract】 Purpose: To evaluate a sign showed in venacavography for diagnosis and guidance of the intervention in BCS with web obstruction of hepatic vem ostium. Materials and methords: 17 cases suspected with BCS received inferior venacavography, in which 5 web obstruction of hepatic vein, which were revealed "nodular feeling defect" in the venacavography were recanalized via jugular or fe-maral vein followed by venogrphy and balloon dilatation, underthe guidanc of the venacavography or/ and sonography. Results: Besides incomplete obstruction of the IVC, 5 cases were presented a nodular feeling defect’ in venacavogram and the recanalization of hepatic vein were successful by puncture. Hepatovenography demonstrated the web obstruction covered the hepatic vein ostium with a convex toward IVC. Re- establishments of hepatic vein outflow was successful which reduced pressure of hepatic vein for 1.84kPa in average. Conclusion: A nodular sign on venacavograph indicates the membranous obstruction of hepatic vein ostium, which is considered a mark for puncture to recanalize hepatic vein.更多还原