原发性肝癌伴右心房癌栓DSA表现  

DSA Manifestation of Primary Liver Cancer with Tumor Thrombus in the Right Atrium

作　　者：刘嵘[1] 王建华[1] 颜志平[1] 刘清欣[1] 程洁敏[1] 邵国良[1] 钱晟[1] 谭小新[1] 

机构地区：[1]上海医科大学中山医院,上海200032

出　　处：《中国肿瘤》2000年第9期425-426,共2页China Cancer

基　　金："九五"国家医学科技攻关项目!(专题号 :96-907-03-01)

摘　　要：〔目的〕分析原发性肝癌伴右心房癌栓的DSA表现。探讨其发生机制和可能出现的临床症状 ,CT、MR、超声心动图表现和治疗方法。〔方法〕回顾性分析7例原发性肝癌伴右心房癌栓的肝动脉造影、下腔静脉造影表现和介入治疗方法。〔结果〕7例肝动脉造影均见肝动脉和肝静脉间有较大的动_静脉瘘和肝静脉癌栓 ,右心房内可见肿瘤染色。6例右心房癌栓和所有肝静脉癌栓一样见较明显的“线条征”。2例经肝TACE术后癌栓内碘油散在沉积。3例合并下腔静脉癌栓和血液回流受阻患者 ,经内支架治疗后明显改善。〔结论〕原发性肝癌右心房癌栓主要由肝动脉供血。CT、MR、超声心动图和DSA对其有较高的诊断价值。肝动脉化疗栓塞术是治疗原发性肝癌右心房转移的方法。睵urpose〕 To analyze the DSA manifestation of the primary liver cancer (PLC) with tumor thrombus(TT)in the right atrium(RA)and to discuss the mechanism of genesis,possible clinical symptoms,appearances of CT,MR,and echocardiography,and treatment for PLC with TT in the RA.〔Methods〕 The hepatic arterial angiography,inferior vena cavography,and the interventional treatment in 7 patients with PLC with TT in the RA were analyzed retrospectively.〔Results〕 The hepatoarterio-hepatovenous shunting,hepatovenous tumor thrombus and tumor stain in the RA were found on the images of hepatic arterial angiography in 7 patients.The tumor stain in the RA in 6 patients and all hepatovenous tumor thrombus were found with obvious“thread and streaks”signs.The lipiodol were deposited in the TT in 2 patients after hepatic arterial chemoembolization.Three patients with TT in the IVC and the blood backflow blockage underwent IVC stents and the symptom were ameliorated.〔Conclusion〕 The blood supply of TT in the RA is major from the hepatic artery.CT,MR,echocardiography and DSA have superior value in diagnosis of TT in the RA.Transcatheter hepatic arterial chemoembolization is the method in the treatment of PLC with TT in the RA.

关 键 词：肝肿瘤 肿瘤癌栓 右心房 DSA表现 介入疗法 治疗 

分 类 号：R735.702[医药卫生—肿瘤]