| Background and ObjectiveBudd-Chiari syndrome is defined as blood backflow obstruction of Hepatic vein and/or Inferior Vena Cava of retrohepatic segment or opening level of Hepatic Vein,which lead to a series of clinical syndrome. It mainly includes silting hemorrhagic Portal Vein Hypertension and Inferior Vena cava Hypertension. In 1842, Lambron reported first Budd-Chiari syndrome. So far, there has been beyond 160 years. After that, George Budd and Hans Chiari described detailedly the clinical manifestations and pathological changes in 1845 and 1899 respectively, so this disease was called Budd-Chiari syndrome. In the World, Budd-Chiari syndrome is a rare disease, but there is high morbidity in China, which is 0.0065%-0.012%. With the deepening research of Budd-Chiari syndrome, there is a great development and progress from diagnosis to treatment. Because of the application of CT, MRI, Color doppler ultrasound and DSA, better effects have been obtained in early and accurate diagnosis of BCS. Nowadays, Interventionnal therapy has been one of the main methods in the treatment of BCS, but there is less report about applied anatomy of Inferior Vena Cava, Hepatic Vein and Portal Vein. Finding differences by researching applied anatomy of Inferior Vena Cava, Hepatic Vein and Portal Vein to normal person and BCS, can improve security for the treatment of BCS.Materials and methods75 Patients of BCS, accepting an MRI examination were reviewed retrospectively in Zheng zhou University second affiliated hospital in June 2007 to December 2010, including 46men and 29women. The ratio was 1.56:1. The age was from 18 to 65, and the average age was 45.7. The course of disease was from 3 months to 15 years. After the examination of MRI, these patients were diagnosed as BCS with DSA. Control group was 162 persons including78 men and 84 women, and the age was from 21 to 65. the average age was 43.5. The members of control group had no cirrhosis, Portal hypertension and the diseases of effecting vascular change.etc. Typings of BCS are obtained by MRI examination. The course, position, diameter and the mutual relationship of adjacent structure of Inferior Vena Cava, Hepatic Vein and Portal Vein are observed and measured. According to the statistical data analysis with SPSS 17.0, the change value between patients of BCS and control group can be obtained.ResultsAccording to observation and measure of MRI imaging, the diameter measurements of Inferior vena cava at the level of Right Atrium and Renal vein about the control right are (25.1±2.8) mm and (24.0±3.2) mm respectively; The diameter measurements of Left Liver vein, Middle Liver vein and Right Liver vein are (7.6±1.0)mm,(8.5±0.9)mm and (10.4±1.1)mm respectively; The diameter measurements of Main Portal vein and the Left Branch and Right Branch of Portal vein are (11.4±1.1)mm,(9.2±0.9)mm,(10.0±1.0)mm respectively. The diameter measurements of Inferior vena cava at the level of Right Atrium and Renal vein about Budd-Chiari Syndrome are (24.6±2.6) mm and (27.9±4.2) mm respectively; The diameter measurements of Left Liver vein, Middle Liver vein and Right Liver vein are (9.6±1.3) mm,(10.0±1.3) mm,(11.6±1.6) mm respectively; The diameter measurements of Main Portal vein and the Left Branch and Right Branch of Portal vein are (12.5±1.6)mm,(10.1±1.3)mm,(10.6±1.3)mm respectively. Through analysis of statistics, there is obvious difference and statistical significance in diameters of Inferior Vena Cava at the level of Renal Vein, Middle Hepatic Vein and Right Hepatic Vein and Portal Vein between BCS patients and control group. The coronal and sagittal MRI scan degree of Inferior Vena Cava is 155.1°±6.7°and 145.7°±5.4°respectively; the angle between right Hepatic Vein and Inferior Vena Cava 58.9°±10.5°; The angle between middle Hepatic Vein and Inferior Vena Cava 60.4°±11.6°; the angle between left Hepatic Vein and Inferior Vena Cava 68.2°±12.3°; the angle between Portal Vein and horizontal line 48.3°±10.7°.Conclusions1.By comparing Budd-Chiari Syndrome with Control group, there is obvious difference in the diameter of Interior Vena Cava at the level of Renal Vein, Middle Liver Vein, Right Liver Vein and Portal Vein and the results are helpful for the diagnosis of Budd-Chiari syndrome;2. The course, position, diameter and the mutual relationship of adjacent structure of Inferior Vena Cava, Hepatic Vein and Portal Vein Through analysing a large of samples of MRI images can be used to guide the treatment of Budd-Chiari syndrome and provide a more effective and safer protection for interventional therapy. |
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