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目的:探讨肝动脉造影及栓塞对肝癌合并下腔静脉癌栓的诊疗价值。方法:回顾性分析10例肝癌并下腔静脉癌栓的重复肝动脉造影和栓塞的影像学表现及介入治疗意义。结果:10例均在肝动脉造影及栓塞前后显示下腔静脉癌栓血管,8例在栓塞后1~3个月内造影显示下腔静脉癌栓的供应血管增多,癌栓增大,其中2例累及心房。2例下腔静脉癌栓血管不显影。栓塞后癌栓内均见碘油沉积,部分癌栓缩小。结论:原发性肝癌之下腔静脉癌栓由肝动脉主要供血,造影有较好的诊断价值。栓塞对癌栓有一定的治疗作用,不排除有促进癌栓生长的可能。治疗上宜采用综合治疗。
Objective: To investigate the value of hepatic artery angiography and embolization in diagnosis and treatment of hepatocellular carcinoma complicated with inferior vena cava tumor thrombus. Methods: The imaging findings and interventional treatment of 10 cases of hepatocellular carcinoma complicated with inferior vena cava tumor thrombus were analyzed retrospectively. Results: All the 10 cases showed inferior vena cava thrombus before and after hepatic artery angiography and embolization. The angiography of the inferior vena cava tumor thrombus in 8 cases within 1 ~ 3 months after embolization showed that the blood vessels increased and the tumor thrombus increased Cases involving the atrium. 2 cases of inferior vena cava tumor thrombus did not develop. Thrombosis embolization were found within the lipiodol deposition, some of the cancer emboli reduced. Conclusion: The primary hepatic carcinoma of the inferior vena cava tumor thrombus is mainly supplied by the hepatic artery, angiography has a good diagnostic value. Embolism has a certain role in the treatment of cancer thrombosis, does not rule out the possibility of promoting tumor growth. Treatment should adopt comprehensive treatment.