彩色多普勒超声对原发性肝癌伴下腔静脉和右心房转移的诊断价值

Diagnostic Value of Color Doppler Ultrasonography in Primary Hepatic Carcinoma with Inferior Vena Caval and Right Atrial Metastases

目的 探讨原发性肝癌伴下腔静脉及右心房转移的超声特征、发生机制及病理过程 ,为临床提供诊断和治疗依据。方法 应用彩色多普勒超声 (CDFI)及 DSA等对 11例原发性肝癌伴下腔静脉及右心房转移患者进行检查。结果 11例原发性肝癌伴下腔静脉及右心房转移患者超声均可见肝原发病灶伴肝静脉癌栓阻塞 ,下腔静脉腔内见中等回声团块 ,其远端扩张 ,生理性搏动消失。心脏超声见右心房内大小不等呈椭圆形或不规则的稍高回声团块 ,其中 9例位于右房后壁、2例位于右房侧壁 ,CDFI见红色血流环绕肿块从三尖瓣流入右室 ,同时肿块内显示较丰富的动脉血流信号。DSA造影提示癌栓由肝动脉供血。结论 超声能显示肝内肿瘤、静脉内癌栓和右心房转移灶的声像图特点以及血流动力学的改变 ,对后续的检查、手术、介入治疗等追踪观察具有重大的价值。

Objective To determine the ulrtrasonic characteristies and pathogenesis of primary hepatic carcinoma with inferior vena caval and right atrial metastases Methods:A total of 11 patients suffered from primary hepatic carcinoma with inferior vena caval and right atrial metastases underwent color Doppler ultrasonography and DSA examination Results Besides the primary lesions,the hepatic veins blocked by cancer embolism were seen in all the 11 patients,and middle echoic masses werealso seen inside the inferior vena cava dilated in the distal part and lost physiological pulsation Different sized masses with different shapes were seen inside the right atrium:9 on the posterior wall;2 on the right wall Red Blood stream rounded along the masses and flowed into the right ventricle through the tricuspid valve Conclusions Color Doppler ultrasonography can display the characteristic and hemodynamic changes of the primary hepatic carcinoma,cancer emboli inside the veins and matastatic masses in the right atrium,and has great value in follow-up observation,examination,operation and interventional therapy