右心房转移性肝癌的多层螺旋CT表现  

Multi-slice helical CT findings of tumor thrombus in the right atrium from hepatocellular carcinoma

作　　者：程红岩[1] 徐爱民[1] 陈栋[1] 徐雯[1] 贾雨辰[1] 

机构地区：[1]第二军医大学东方肝胆外科医院影像科,上海200438

出　　处：《中华放射学杂志》2003年第11期989-991,共3页Chinese Journal of Radiology

摘　　要：目的　评价右心房转移性肝癌的多层螺旋CT表现。方法　患者 11例 ,男 10例 ,女1例。所有患者均经多层螺旋CT 3期薄层扫描 ,发现肝内肿瘤和右心房充盈缺损。临床、实验室检查和影像学上均诊断为肝癌。结果　 10例肝癌为巨块型 ,1例为多结节融合型 ;右心房癌栓大小不等 ,最大为 5 1cm× 7 7cm ,最小为 1 5cm× 2 1cm ;形态规则或不规则 ,可表现为圆形、卵圆形和水滴样 ,边缘清楚或模糊 ;平扫不易发现 ,增强 3期扫描均表现为右心房结节状、块状充盈缺损 ,在动脉期显示最明显 ,延迟期显示癌栓较为完整 ;癌栓在动脉期和门脉期可有轻度强化。下腔静脉和肝静脉均受侵犯 ,8例门静脉受侵犯。结论　当肝癌伴下腔静脉、肝静脉和右心房充盈缺损时 。Objective To describe the multi-slice helical CT findings of tumor thrombus from hepatocellular carcinoma (HCC) in the right atrium. Methods Triple-phase scan of multi-slice helical CT with 5-mm-thick-section was performed in 11 patients. The HCC was diagnosed by clinical, AFP, and imaging examinations. Results Huge type HCC was found in 10 patients, and multi-node confluence pattern HCC in one case. The size of tumor thrombus in the right atrium was from 5.1 cm×7.7 cm in maximum to 1.5 cm×2.1 cm in minimum. There were regular or anomalous patterns for the thrombus, including round, oval-round, and taper shape. The tumor thrombus was not identified easily in unenhanced scan. The filling defect of the right atrium was showed during triple-phase scan. The excellent demonstration of tumor thrombus was in arterial phase and delay phase scan. The tumor extending to inferior vena cava and hepatic vein was detected in all 11 patients, and portal vein in 8 patients. Conclusions When the HCC was associated with filling defect of the inferior vena cava, hepatic vein, and the right atrium, the diagnosis of the tumor thrombus of the right atrium can be established.

关 键 词：右心房 癌栓 多层螺旋CT 充盈缺损 转移性肝癌 肝静脉 动脉期 显示 延迟 扫描 

分 类 号：R735.7[医药卫生—肿瘤]