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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 investigate the imaging findings of primary hepatocellular carcinoma with right atrial fibrillation and the clinical efficacy of arterial chemoembolization. Materials and Methods Retrospective analysis of 9 cases of primary liver cancer and right atrial fibrillation in patients with imaging data and arterial chemoembolization. Results Conventional abdomen CT scan range, scan atrial thrombi were missed diagnosis, enhanced scan missed diagnosis in 7 cases; atrial thrombus CT scan was equal density, mild enhancement of arterial phase showed nodular filling defect, embolization of the degree of tumor embolization to varying degrees Lipiodol deposition; tumor invasion of the hepatic vein, inferior vena cava to right atrium in 8 cases, a direct violation of the inferior vena cava into the right atrium in 1 case, angiography showed “stripe sign ”. The survival rates at 6 months and 12 months postoperatively were 77.8% (7/9) and 33.3% (3/9), respectively. The median survival time was 9.5 months. Conclusion If the hepatic carcinoma is filled with hepatic veins, inferior vena cava and right atrium, the right atrial thrombus can be diagnosed by “stripe sign ”. The chemoembolization is safe and effective in the treatment of primary hepatocellular carcinoma and right atrial cancer thrombus method.