Retrospective Comparative Study On Ultrasound And CT Diagnosis Of Budd-Chiari Syndrome

Objective: Diagnosis of Budd-Chiari syndrome (BCS) mainly rely on imagingexamination at present. Digital substraction angiography (DSA) is acknowledged as thegolden standard for diagnosis. The objective of this study was to do a comparativeimageology research on ultrasound and CT examination, with the results of DSA as thegolden standard, and to discuss the advantages and disadvantages of each method inorder to better guide clinical interventional therapy.Methods: Retrospective comparative study on82patients of suspected BCS, fromJanuary2002to October2011,and they are all examined by US,CT and DSA in theFirst Affiliated Hospital of Dalian Medical University. Through the DSA, there are46patients with IVC type,2patients with HV type and20with HV combined IVC type.According to the examine results, each type of BCS was observed by ultrasound and CTimaging. With DSA as the golden standard, the sensitivity，specificity，positivepredictive value，negative predictive value and accuracy of ultrasound and CT werecalculated and the clinical diagnostic accuracy of US and CT was compared by X2test,in order to analyse and compare their respective advantages and disadvantages.Results:1.With DSA as the golden standard, the sensitivity, specificity positive predictivevalue, negative predictive value and accuracy for ultrasound in BCS were91.2%,57.1%,91.2%,57.1%and85.4%respectively.2.With DSA as the golden standard, the sensitivity, specificity positive predictivevalue, negative predictive value and accuracy for CT in BCS were91.2%,64.3%,92.5%,60.0%and86.6%respectively.3. There was no statistical differences of diagnostic accuracy of BCS betweenUS and CT(P=0.5).Ultrasound was better than CT in observing intrahepatic collateral vessels(P1=0.01), but less accurate in examining the change of solid visceral organs,such as liver and spleen(P2=0.009，P3=0.034). There were no statistical difference inobserving extrahepatic collateral vessels (P4=0.08).Conclusions:1. Ultrasound and CT both are important diagnostic methods for accuratediagnosis of BCS.2. Ultrasound is an easy, cheap and contrast agent-free examination method in theinitial clinical screening of BCS.3. CT is a valuable examination method in understanding the viseral organs andvessel in patient with BCS.