门静脉癌栓的超声诊断

目的:探讨对门静脉癌栓的超声诊断,为提高肝癌的诊断率。方法:回顾性分析了31例肝癌伴门静脉癌栓患者的超声检查资料,重点观察肝癌的部位及门静脉内部回声、血流特点。结果:肝癌并门静脉癌栓发生率占35%(31/88),好发部位依次为主干、左支、右支,回声特点及形态均为低回声、内部回声欠均匀,88%(23/26)的充满型癌栓所在支血流完全中断,12%(3/26)充满型癌栓可见不规则线状或星点状肝门脉血流信号。5例弧立型癌栓附着处血流色彩充盈缺损,癌栓侧壁与管腔之间的空隙血流束变细,流速相对增快,肝动脉血流加快,与CT对比敏感性高。结论:门静脉癌栓的检出,对肝内占位性病变良恶性的判断是一个有力的依据。

Ultrasonographic Diagnosis of Tumor Thrombosis in Portal Vein

Objective:To discuss the ultrasonographic diagnosis of tumor thrombosis in portal vein and improve the diagnostic rate of hepatocellular carcinoma(HCC).Methods:The data of 31 cases of hepatocellular carcinoma with tumor thrombosis in portal vein were retrospectively analyzed.Attention was given to the part of hepatocellular carcinoma and the internal echo,blood flow characteristics of portal vein.Results:The incidence of hepatocellular carcinoma with tumor thrombosis in portal vein was 35%(31/88).The frequent sites were main portal vein,left portal vein branch,right portal vein branch.The echo property and the forms were lower echo and lack of uniform.And the blood flow of the branch with cancerous embolism of 88%(23/26) was wholly blocked,but only 12%(3/26) of it can be shown irregular linear or star punctuation blood flow in channels and vessels of hepatic portal.Among five(ca-)ses,the blood flow color was filling defect in tumor thrombosis attachment,the blood flow was thinner between the sidewall of tumor thrombosis and the lumen,the velocity of blood flow became faster comparatively,the blood flow of hepatic artery ran faster and the sensitivity was higher than CT.Conclusion:Detection of tumor thrombosis in portal vein is of effective foundation for judging benign and malignancy of intrahepatic space occupying lesion.