The Comparative Study Of Ultrasond And CT In Diagnosis Of Hepatic Veno-occlusive Disease

Objective To evaluate the features of the ultrasonography and CT in the diagnosis of hepatic veno-occlusive disease (HVOD) and compare the diagnostic value of two methods.Materrials and Methods 32 cases of HVOD were confirmed by liver biopsy (12 cases) and clinical diagnosis (20 cases), male 25 cases and female 7 cases, including acute (16), subacute (10), and chronic cases (6). All patients underwent ultrasound and Tri-phase enhancement scan.To analysis all the patients'ultrasonography and CT files retrospectively, record the size of the liver, liver echo and density, hepatic vein,and portal doppler blood flow, density features of every phase in enhanced liver. Compare the ultrasound and CT diagnostic accuracy of the HVOD, and statistical analysis the datas.Results The performance characteristics of ultrasound in HVOD include: the echo of liver around hepatic veins decreased, the echo of hepatic vein wall enhanced and hepatic vein became thinner, portal vein transient reflux. In acute and subacute phase, CT scan showed typical liver density reduced , hepatic artery enlarging in artery phase, liver showed patchy or map-like enhanced in portal and delayed phases. Comparison of two methods, in acute phase, all 16 cases were correctly diagnosed by ultrasonography or CT due to typical manifestations; in subacute phase, 8/10 and 6/10 cases were correctly diagnosed by ultrasonography and CT, respectively; in chronic phase 4/6 cases were correctly diagnosed by ultrasonography, but all were not diagnosed by CT. The diagnostic coincidence rates of HVOD were 87.50% (28/32) and 68.75% (22/32) for ultrasonography and CT with no significant difference between them (χ2=2.5, P>0.05).Conclusion⑴In acute phase, CT and ultrasonography share the same diagnostic value in the diagnosis of HVOD, ultrasonography is the preferred.⑵In subacute phase, patients with HVOD examed by ultrasound and enhanced CT have their own characteristics, can be complementary.⑶In chronic phase, Tri-phase enhancement scan has no typical performance, ultrasonography is the preferred.⑷In the differential diagnosis of Budd - Chiari syndrome, ultrasonography is the better.