门静脉癌栓佐证弥漫性肝癌的诊断研究

Exploring on portal cancerous thrombosis Proving the diffuse type of primary hepatocellular carcinoma(PHC)

目的 探讨弥漫性肝癌的诊断依据以及提高其临床诊断符合率。方法 以患者临床表现为线索，以Ｂ 超包括ＣＤＦＩ 为主要手段，结合其它影像学方法进行综合分析研究。结果 大部分病人表现为不同于普通肝病的发热、乏力、黄疸、肝区疼痛和肝脏肿大；Ｂ 超示肝形态增大、饱满，尤以原本硬化、萎缩的右肝为著；门静脉平均为１７－４ ±３－１ｍ ｍ ；尤其是原本无回声的门静脉系统出现了实质组织回声的图像，即门静脉癌栓（ＰＣＴ） ，它分为三种类型：光团状、枯枝状和絮片状；彩色超声多普勒（ＣＤＦＩ） 示其内有高频的动脉血流频谱。本文还讨论了ＰＣＴ 与门脉血栓（ＰＶＴ） 、ＰＣＴ 与门静脉气泡的鉴别要点。

Aim To explore the diagnostic basis of the diffuse type of PHC and elevate its detectable rate.Methods Clinical data (including history,symptoms and signs)mainly provided as clues,B type of Ultrasound as the important measure and the other kinds of imaging were totally evaluated.Results Most of the patients expressed fever,leanness,jaundice,hepatalgia and hepatomegaly beyound description of the ordinary hepatopathy;B type of ultrasound showed the plumpness of liver,especially in the right lobe of the liver that had originally showed as cirrhosis and atrophy.The free echo disappeared and substituted for the echo of parenchymal tissues:portal cancerous thrombosis(PCT) including 3 types(ball,branch and slice)in the portal vein system.There are hyperfrequency spectrum of arterious blood flow in PCT with CDFI.The paper,otherwise,also discussed the differential diagnosis:PCT and portal vein thrombosis (PVT),PCT and bubble in the portal vein.Conclusion The most important foundation is PCT during diagnosing the diffuse type of PHC.