대한핵의학회지 (1967년~2009년)
대한핵의학회지 1988;22(1)47~7
하대정맥 폐색으로 인한 Budd - Chiari 증후군의 간신티그램 소견 ( Hepatic Scintigraphic Findings of Budd - Chiari Syndrome due to Inferior Vena Caval Obstruction )
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Author 김성훈(Sung Hoon Kim),정수교(Soo Kyo Chung),변재영(Jae Young Byun),이성용(Sung Yong Lee),신경섭(Kyung Sub Shinn),김춘열(Choon Yul Kim),박용휘(Yong Whee Bahk),
Affiliation
Abstract

Budd-Chiari syndrome (BCS) is a rare clinical entity characterized by post-sinusoidal portal hypertension caused by the obstruction to the hepatic vein outflow. The diagnosis is suggested by hepatic scintigraphy and is usually confirmed by hepatic venography, inferior vena cavography and biopsy. The scintigraphic finding of BCS caused by the obstruction of main hepatic vein has been reported to consist typically of hypertrophy of the caudate lobe with increased radionuclide accumulation. Such a typical finding has been accounted for by the fact that the venous outflow from the caudate lobe is preserved when the main hepatic vein is obstructed. But usually, the hepatic venous outflow from the caudate lobe is also obstructed in BCS due to inferior vena caval obstruction. So hepatic scintigraphic findings of BCS due to inferior vena caval obstruction show different findings as compared with the BCS due to hepatic vein obstruction. We evaluate the hepatic scintigrams of the 13 cases of BCS due to inferior vena caval obstruction and review the literatures. The results are as follows: 1) We cannot observe the caudate lobe hypertrophy with increased uptake, which is known as a classic finding in BCS due to hepatic vein obstruction. 2) The most prominent hepatic scintigraphic findings of BCS are nonhomogenous uptake in the liver with extrahepatic uptake in the all cases. 3) We can see cold areas at the superior aspect of right hepatic lobe in 7 cases (54%). This is a useful finding suggesting BCS due to inferior vena caval obstruction.

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