| 肝癌合并门脉癌栓和血栓的影像学类型的认识及临床应用 |
| 投稿时间：2010-04-27 点此下载全文 |
| 引用本文：丁汇清,张海军,杨立民,乔乃春,张名忠,王炳良,朱云炜.肝癌合并门脉癌栓和血栓的影像学类型的认识及临床应用[J].医学研究杂志,2010,39(9):64-65 |
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| 基金项目:江苏省连云港市“科教兴卫工程”学科带头人科研课题(2008-ZC235) |
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| 中文摘要:目的探讨肝癌合并门脉癌栓和血栓的影像学类型及临床意义。方法肝癌伴PVTT 32例，肝癌伴PVBT 18例。均排除肝动静脉瘘。 肝动脉插管介入治疗后，肝癌伴PVTT 32例、肝癌伴PVBT中4例做了门静脉途径介入治疗。结果依据门静脉栓子、管壁受累情况，将肝癌伴PVTT的影像学表现分型：门静脉完全阻塞型17例（17/32）、不全阻塞型6例（6/32）和侵犯门静脉管壁型9例（9/32）。 PVTT、PVBT和门静脉壁的影像学检查所显示的供血情况：18例PVBT中,彩超检查仅1例（1/18）示PVBT内疑有少许血供。 32例PVTT，彩超检查示有血供29例（29/32），HCT和DSA显示PVTT内有血供的分别为26例（26/32）、21例（21/32）。 PVBT与PVTT血供有非常显著差异［χ20.01 (1)=38.11,P＜0.01］。肝癌伴PVBT组影像学表现分型：门静脉完全阻塞型10例（10/18）和不全阻塞型6例（8/18）。结论加深对各种门脉栓子的影像学表现及类型的认识，具有一定临床意义。 |
| 中文关键词:肝癌 门静脉 癌栓 血栓 类型 影像学 |
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| Study on the Imaging Type of Hepatocellular Carcimoma with the Portal Vein Tumor Thrombus and Blood Thrombus |
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| Abstract:ObjectiveTo investigate the image types of hepatocellular carcinoma(HCC)with the portal vein tumor thrombus (PVTT) and the portal vein blood thrombus(PVBT) and its clinical signifecance.Methods32 cases with PVTT and 18 cases with PVBT treated by transcantheter hepatic arterial chemo-embolization(THAE) were reported.Patients with hepatic arteio-venous fistula were excluded.Then 2～3 weeks after TAHE, PVTT patients (n=32 cases) and PVBT patients (n=4 cases) were treated by the portal-trace under CDUS and helical CT-guided. ResultsAccording to the degree of portal vein lumen obstruction and invasion the portal wall by PVTT, the imaging classification of PVTT will be divided into the type of complete obstruction of the portal vein lumen(n=17 cases,17/32), the type of incomplete obstruction(n=6cases,6/32) and the type of invasion the portal wall (n=9 cases,9/32). The findings of the imaging of the blood supply to PVTT and PVBT showed that 1 case (1/18) of PVBT with uncertainly blood supply was present under color doppler ultrasound (CDUS)examination. In 32 PVTT cases, CDUS examination revealed some blood supply in 29 cases(29/32).Helical CT and DSA showed that the blood supply within PVTT were 26 cases (26/32) and 21 cases(21/32) respectively.There was a highly significant difference in blood supply between PVTT and PVBT［χ20.01 (1)=38.11,P＜0.01］. The imaging classification of PVBT was divided into the type of complete obstruction of the portal vein lumen of 10 cases(10/18) and the type of complete obstruction of 8 cases(8/18). ConclusionIt has clinical significance to enhance the understanding of the various types of imging findings of portal vein emboli. |
| keywords:Hepatocellular carcinoma Portal vein thrombus Type Imaging |
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