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- Title
Accuracy of computed tomographic angiography in the diagnosis of patients with inferior vena cava partial obstruction in Budd-Chiari syndrome.
- Authors
Liu, Shi ‐ Yi; Xiao, Ping; Cao, Hui ‐ Cun; Jiang, Hao ‐ Sheng; Li, Tian ‐ Xiao
- Abstract
Background and Aim The diagnosis of the partially obstructed inferior vena cava (IVC) in Budd-Chiari syndrome (BCS) patients has received little attention. We aimed to evaluate the diagnostic accuracy of computed tomographic angiography (CTA) for patients with BCS and a partially obstructed IVC. Methods A total of 329 patients with BCS and an obstructed IVC were endovascularly treated with balloon dilation and/or stent placement. All patients underwent a CTA examination prior to endovascular treatment, and the data were retrospectively reviewed. The presence of a round, oval, irregular shape or jet sign low-density area without enhancement within the enhanced proximal IVC was considered a sign of a partially obstructed IVC. Digital subtraction angiography was used as the gold standard. Results The results from the digital subtraction angiography revealed a partially obstructed IVC in 108 BCS patients and a complete obstruction in 221 patients. The CTA discovered a partially obstructed IVC in 99 patients and a completely obstructed IVC in 230 patients. From the CTA results, 15 were false negatives, and six were false positives. The patient-based evaluation yielded an accuracy of 93.6%, a sensitivity of 86.1%, specificity of 97.3%, positive predictive value of 93.9%, and negative predictive value of 93.5% for the detection of BCS patients with a partial IVC obstruction. Conclusions Computed tomographic angiography offered a high diagnostic accuracy and sensitivity in BCS patients with a partially obstructed IVC. The low-density area within the enhanced proximal IVC above the membrane in artery phase can be considered a reliable indicator of a stenotic IVC in BCS patients.
- Subjects
VENA cava inferior diseases; HEPATIC veins; COMPUTED tomography; ANGIOGRAPHY; SURGICAL stents; ENDOVASCULAR surgery; DISEASES; DIAGNOSIS
- Publication
Journal of Gastroenterology & Hepatology, 2016, Vol 31, Issue 12, p1933
- ISSN
0815-9319
- Publication type
Article
- DOI
10.1111/jgh.13420