| ObjectiveTo explore the change of hepatic caudate lobe(HCL)and its clinical value in patients with Budd-Chiari syndrome(BCS)using enhanced MRI.Materials and MethodsEnhanced MRI data of 43 patients with BCS(BCS group),36 patients with hepatitis B virus(HBV)-related cirrhosis(Hepatitis B cirrhosis group),and 31 subjects with roughly normal liver(normal group)were collected retrospectively from April 2014to April 2017.The 43 patients with BCS were confirmed by clinical,ultrasound,MRI and digital subtraction angiography(DSA).Among them,the caudate vein of the liver could be seen in 33 cases.According to whether the course of BCS was≤6 months,patients were divided into acute and chronic,10 patients were acute and 23 patients were chronic.According to the obstruction site,the BCS was divided into the inferior vena cava type or mixed type,hepatic vein type;26 cases were inferior vena cava type or mixed type,and 7 cases were hepatic vein type.Thirty-six patients with hepatitis B cirrhosis(hepatitis B cirrhosis group)were exclude liver occupying lesions and severe cardiopulmonary insufficiency.Thirty-one cases in the normal group were exclude viral hepatitis,large space-occupying lesions of the liver(≥5 cm),hepatic caudate lobe-occupying lesions and severe cardiopulmonary insufficiency.Transverse diameter of HCL and display rate of HCL vein among the three groups were measured and compared.Diameter of HCL vein was compared between different disease course groups and lesion type groups,respectively.The ROC curve of BCS diagnostic value of transverse diameter of HCL was drawn.The value of hepatic caudate lobe diameter for the diagnosis of BCS was analyzed and evaluated.ResultsThe average diameter of the hepatic caudate lobe in the BCS group was(54.34±17.49)mm,(35.83±6.66)mm in normal group,(37.34±8.64)mm in hepatitis B cirrhosis group.The transverse diameter of the hepatic caudate lobe in the BCS group was larger than that in the normal group and the hepatitis B cirrhosis group.The difference was statistically significant(P<0.01).There was no significant difference in the transverse diameter of the hepatic caudate lobe between the normal group and the hepatitis B cirrhosis group(P=0.804).The rate of hepatic caudate vein in the BCS group was 76.74%,higher than the normal group(22.58%)and the hepatitis B cirrhosis group(25.00%).The differences were statistically significant(χ~2=21.278、21.070,P<0.01).There was no significant difference in the rate of hepatic caudate veins between the normal group and the hepatitis B cirrhosis group(χ~2=0.054,P>0.05).Among the 43patients with BCS,33 patients had hepatic caudate vein,the diameter of the caudate vein was from 1.60 to 7.90 mm,and the average diameter was(4.40±1.59)mm.The average diameter of the caudate vein was 2.81±0.69mm in 10 patients with acute disease,and which was 5.09±1.35mm in 23 patients with chronic disease.The average diameter of caudate vein was 4.85±1.43mm in 26 cases of inferior vena cava type or mixed type,and which was 2.71±0.81mm in 7 cases of hepatic vein type.The caudate vein diameter of patients with chronic BCS was larger than that of acute BCS,the difference was statistically significant(t=-5.001,P<0.05).Caudal vein diameter of patients with inferior vena cava or mixed BCS was larger than that with hepatic vein type,the difference was statistically significant(t=-3.781,P<0.05).Area under the curve of ROC was 0.861,with 95%CI(0.777~0.946).When the transverse diameter of HCL was 43.49 mm,sensitivity and specificity were 76.74%and 90.32%,respectively.Conclusion:The transverse diameter of the hepatic caudate lobe in the BCS group is larger than that in the normal group and the hepatitis B cirrhosis group.The rate of hepatic caudate veins in the BCS group is higher than that in the normal group and the hepatitis B cirrhosis group.Cervical vein diameter in patients with chronic BCS is greater than acute BCS.Caudal vein diameter of patients with inferior vena cava or mixed BCS is larger than hepatic vein type BCS.Enlarged HCL and HCL vein are characteristic changes of BCS patients,and have certain value in disease diagnosis and evaluation. |
