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CT venography in diagnosis of hepatic veno occlusive disease induced by aedum aizoon

ZHENG Junyi;LI Mengya;ZHANG Yuelang;HE Shuixiang;YIN Yan;Department of Gastroenterology,the First Affiliated Hospital of Xi'an Jiaotong University;  
Objective To investigate the value of CT venography(CTV) in diagnosis of hepatic veno occlusive sisease(HVOD).Methods Eight cases of HVOD induced by sedum aizoon were reported,and the clinical manifestations,imaging examination and liver puncture biopsy were reviewed to evaluate the diagnostic value of CTV.Results 8 patients had taken sedum aizoon for a long time and then presented with dyspepsia,inappetence,weakness,dull pain in right upper quadrant,hepatomegaly,ascites and abnormal liver function.CTV showed heterogeneously enhanced areas like "geographic sign" and intrahepatic vein could not be shown clearly.Hepatic segment of inferior vena cava was compressed like "comma sign",and no collateral circulation could be detected.2 cases were underwent liver puncture biopsy,which showed constriction,emphraxis,dilation and congestion in the hepatic sinusoidal.Conclusion Sedum aizoon is a common cause in aged patient with HVOD.The clinical manifestations of HVOD are not specific and the diagnosis is made by liver biopsy which has high risk of bleeding.Noninvasive approach is needed in diagnosis of HVOD.CTV has higher sensitivity and specificity than routine examination such as ultrasonography.It can improve the accuracy of diagnosis and make up for the disadvantages of histological examination.
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