肝静脉阻塞的血管造影表现

目的 评价肝静脉阻塞的血管造影表现。方法 肝静脉阻塞患者45例，男23例，女22例；年龄9～54岁。全部病例均行下腔静脉造影和肝静脉造影。结果 肝静脉阻塞而下腔静脉通畅37例，肝静脉和下腔静脉同时阻塞8例。肝静脉阻塞而下腔静脉造影表现为肝内段下腔静脉局限性或普遍性狭窄31例，肝内段下腔静脉管径正常者12例，肝静脉开口处出现隔膜膨出征5例，副肝静脉开口处出现隔膜膨出征4例，肝静脉之间交通支形成45例。结论 下腔静脉造影能对肝静脉有无阻塞做出初步判断，隔膜膨出征是肝静脉和副肝静脉开口处膜性阻塞的直接征象，选择性肝静脉造影是诊断肝静脉阻塞的可靠依据。

The angiographic demonstration of hepatic vein obstruction

Objective To evaluate the angiographic feature of hepatic vein obstruction. Methods Forty-five patients (male 23, female 22, age 9-54 years) suffered from hepatic vein obstruction.The inferior vena cavography and the hepatic venography were performed in all cases.Results IVC was free in 37 patients with hepatic vein obstruction, both IVC and HV were obstructed in 8 patients. The local or long stenosis of IVC was found in 31 inferior vena cavography.The diameter of IVC was normal in 12 patients.The sign of membranous dome was found in hepatic vein orifice in 5 cases and in accessory hepatic vein orifice in 4 cases.Intrahepatic venous collaterals were found in 45 cases.Conclusion Hepatic vein obstruction can be reproached primarily in inferior vena cavography, the membranous dome is a direct sign of membranous obstruction of HV and AHV in inferior vena cavography.The selected hepatic venography can provide reliable evidence to diagnose hepatic vein obstruction.