肝癌门静脉癌栓分型的影像学意义

A study on imagination features of tumor thrombi in the portal vein of primary liver cancer

目的探讨肝癌门静脉癌栓分型的影像学意义。方法以肝癌门静脉癌栓生长特征为基础 ,建立Ⅰ0 ～Ⅳ共 5型 8亚型癌栓分型标准 ,比较 130例肝癌门静脉癌栓的影像学诊断符合率。结果临床就诊者门静脉癌栓影像学显示 85 %属Ⅱ～Ⅲ型 (110 / 130 )。影像学Ⅰ、Ⅱ、Ⅲ、Ⅳ型癌栓病人获手术切除率分别为 6 2 % (5 / 8)、16 % (10 / 6 2 )、10 % (5 / 4 8)和 0 (0 / 12 ) ,接受化疗栓塞 (TACE)治疗分别为 38% (3/ 8)、4 0 % (2 5 / 6 2 )、2 7% (13/ 4 8)和 16 % (2 / 12 )。结论影像学门静脉癌栓分型有助于肝癌诊治并判断预后。

Objective To study on imagination features of tumor thrombi in the portal vein of primary liver cancer (PLC). Methods We established a new type system of tumor thrombi, with Ⅰ 0 to Ⅳ, a total of 5 types and 8 sub-types in the portal vein of PLC based on normal intrahepatic portal vein anatomy and growing features of the tumor thrombi. The relationship between the types and the imaging diagnosis of 130 PLC cases with tumor thrombi in the portal vein was studied. Results 85%(110/130) cases of PLC with tumor thrombi in the portal vein belongs to type Ⅱ or Ⅲ when being first diagnosed in the hospital. The resectability rates for type Ⅰ, Ⅱ, Ⅲ, Ⅳ were 62%(5/8), 16%(10/62), 10%(5/48), 0 (0/12), respectively, and chemoembolization therapy (TACE) was given in 38%(3/8), 40%(25/62), 27%(13/48), 16%(2/12), respectively. Conclusions The new types of tumor thrombi are helpful for diagnosis and treatment of PLC with tumor thrombi in the portal vein.