论文部分内容阅读
〔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。
[Objective] To analyze the DSA appearance of primary liver cancer with right atrium tumor thrombus. Explore the mechanisms and possible clinical symptoms, CT, MR, echocardiographic performance and treatment. [Methods] Retrospective analysis of hepato-arteriography, inferior vena cava angiography performance and interventional therapy were performed in 7 cases of primary liver cancer with right atrium tumor thrombus. 〔Results〕 In 7 patients with hepatic arteriography, there was a large dynamic-venous fistula and hepatic vein tumor thrombus between the hepatic artery and hepatic vein. Tumor staining was seen in the right atrium. 6 patients with right atrial tumor embolism and all hepatic vein tumor embolism see the more obvious “line sign.” Two cases of transhepatic TACE postoperative intracranial iodized oil scattered in the deposition. Three patients with inferior vena cava tumor emboli and obstructed blood flow were significantly improved after stent treatment. [Conclusion] The primary right hepatic tumor thrombus in primary liver cancer is mainly supplied by the hepatic artery. CT, MR, echocardiography and DSA have higher diagnostic value. Transcatheter arterial chemoembolization is a method for the treatment of right atrial metastasis of primary hepatic carcinoma.