摘要
目的探讨原发性肝癌并右心房癌栓的影像学表现及动脉化疗栓塞的临床疗效。资料与方法回顾性分析9例原发性肝癌并右心房癌栓患者的影像学资料及动脉化疗栓塞疗效。结果常规腹部CT扫描范围,平扫心房癌栓均漏诊,增强扫描漏诊7例;心房癌栓CT平扫呈等密度,动脉期轻度强化呈结节样充盈缺损,栓塞后癌栓内不同程度碘油沉积;肿瘤侵犯肝静脉、下腔静脉至右心房8例,直接侵犯下腔静脉进入右心房1例,血管造影均显示"条纹征"。术后6个月、12个月生存率分别为77.8%(7/9),33.3%(3/9),中位生存期为9.5个月。结论原发性肝癌若肝静脉、下腔静脉与右心房出现充盈缺损、"条纹征"即可诊断右心房癌栓;化疗栓塞是治疗原发性肝癌并右心房癌栓的安全、有效方法。
Objective To evaluate the imaging findings of primary hepatic carcinona（PHC） with right atrial tumor thrombus（RATT） and the clinical efficacy of the transcatheter chemoembolization（TACE）.Materials and Meth-ods The imaging findings of 9 cases of PHC with RATT and therapeutic Efficacy of TACE were analyzed retrospectively.Plain chest CT and enhanced abdominal CT scans were performed pre-and post-TACE in all patients.Results Missed diagnosis of RATT at the scope of conventional and Enhanced abdominal CT scan were in 9 cases and 6 cases respectively.RATT was showed isodensity on plain CT scan and a nodular filling defect in right atrium（RA） with a slight enhancement in arterial phase.Lipiodol deposited in RATT to a varying degree after TACE.Invasion to hepatic vein（HV）,inferior vena cava（IVC） and RA were found in 8 cases,direct invasion to IVC and extending to RA were found in 1 cases.On angiography,the ＂stria＂ sign was showed in all cases.6 and 12 month survival rate was 77.8%（7/9） and 33.3%（3/9） retrospectively,and the median survival was 9.5 months.Conclusion RATT could be diagnosed when PHC coexisted with filling defect in the RA,HV,IVC,and the ＂stria＂ sign.TACE is a safe and effective treatment modality for PHC with RATT.
出处
《临床放射学杂志》
CSCD
北大核心
2011年第1期86-89,共4页
Journal of Clinical Radiology
关键词
肝肿瘤
癌栓
右心房
化疗栓塞
体层摄影术
X线计算机
Liver neoplasms Tumor thrombus Right atrium Chemoembolization Tomography
X-ray computed
