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1.
熊青云 《中华现代影像学杂志》2006,3(11):1037-1038
目的探讨彩色多普勒在肝癌合并门静脉癌栓的应用价值。方法对应用彩色多普勒诊断32例肝癌合并门静脉癌栓的临床资料进行回颐性分析。结果 癌栓常波及门静脉右支(26/32);肝右动脉扩张,血流阻力下降,血流速度增高;弥漫型肝癌发生门静脉癌栓几率最高(23.8%)。结论彩色多普勒对肝癌合并门静脉癌栓诊断、癌栓血流分析和肝动脉血流的观察、对肝癌处理方式的选择及预后评估都有重要指导意义。 相似文献
2.
彩色多普勒在肝癌合并门静脉癌栓检查中的应用 总被引:5,自引:0,他引:5
常见的门静脉栓子为肝癌合并为肝癌合并癌栓,少数为血栓。以往B超超声对栓子的显示率较高,但对其定性诊断还有相当程度的困难。本文通过对48例门脉癌检的血流状况显示,分析表明:(1)在有癌栓的门脉周围均可见扩张的肝动脉分支;(2)部分可见进入栓子内的滋养动脉;(3)少数形成动脉-门脉分流;(4)门静脉原向肝的血流可转变为离肝或双向交替出现。 相似文献
3.
目的 探讨高强度聚焦超声(HIFU)联合肝动脉化疗栓塞(TACE)治疗门静脉癌栓(PVTT)的安全性和有效性。方法将42例原发性肝癌(HCC)合并门静脉癌栓(PVTT)患者分为两组,A组(22例)采用HIFU联合TACE进行治疗,B组(20例)单纯采用TACE治疗。结果HIFU联合TACE组治疗后PVTT有5例消失,12例缩小,比TACE组疗效明显(P〈0.05)。HIFU联合TACE组,有11例患者恢复门静脉血流,癌栓内血供较单纯TACE治疗组明显减少(P〈0.05)。联合治疗组中位生存期13.8个月,较同期TACE组中位生存期7.9个月明显延长(P〈0.05)。结论HIFU联合TACE治疗PVTT是一种新的安全、有效、微创的治疗方法,能明显提高患者生活质量,延长寿命。 相似文献
4.
门静脉癌栓分型在肝癌经皮肝动脉栓塞化疗术治疗中的意义 总被引:1,自引:0,他引:1
目的 探讨不同门静脉癌栓分型在肝癌经皮肝动脉栓塞化疗术(TACE)治疗中的意义和疗效。方法 269例肝癌伴门静脉癌栓患者分为TACE组(217例)和对照组(52例)。比较不同癌栓分型的治疗效果和预后情况。结果 TACE治疗对Ⅰ型癌栓治疗效果明显,Ⅱ型、Ⅲ型有效,Ⅳ型无效。TACE治疗可延长肝癌伴门静脉癌栓患者生存期(P〈0.01),门脉癌栓分型程度与患者预后呈负相关。结论 Ⅰ~Ⅲ型适宜TACE治疗.Ⅳ型不宜行TACE治疗。门脉癌栓分型是决定患者治疗效果和预后的重要因素,对评价肝癌TACE治疗疗效和患者预后有指导意义。 相似文献
5.
目的探讨肝移植术后肝动脉与门静脉血流动力学变化的相关关系及其对早期诊断血管并发症的意义。
方法应用彩色多普勒超声观察56例肝移植患者移植肝脏形态学变化、肝动脉峰值流速(Vs)、肝动脉阻力指数(RI)、门静脉及肝静脉平均流速(Vm)等指标,并以60例健康成人肝脏的血流动力学参数作为正常对照组。
结果肝移植术后无并发症的移植肝在术后1个月内肝动脉Vs低于正常对照组,而门静脉Vm高于正常对照组,差异有显著性意义(P〈0.05)。移植肝脏组的肝静脉Vm与正常对照组的差异不具有显著性意义(P〉0.05)。1个月后,肝动脉、门静脉和肝静脉的血流速度基本上趋于正常。移植肝发生急性门静脉血栓形成时肝动脉Vs较术后同时期无术后并发症的移植肝的肝动脉Vs增高。而在肝动脉栓塞时门静脉Vm较同时期无术后并发症的移植肝的门静脉Vm增高。移植肝的肝动脉低RI与肝移植术后肝动脉并发症有明显相关性。
结论肝移植术后近期内门静脉和肝动脉血流速度分别呈先高后低及先低后高的反向渐变趋势,充分认识两者的相关关系对及早发现移植肝血管并发症具有重要意义。 相似文献
6.
目的:探讨肝叶切除经肝断面取癌栓治疗原发性肝癌合并门静脉癌栓的临床疗效。方法:60例原发性肝癌合并门静脉癌栓患者行肝叶或肝癌切除并取癌栓,并与同期肝癌无癌栓者的手术疗效进行对比分析。结果:门静脉癌栓组6、12个月生存率分别为88.3%、51.7%,与单纯肝癌切除组的93.3%、62.2%比较,无显著性差异(P〉0.05)。结论:原发性肝癌合并门静脉癌栓手术切除肝癌并于肝断面门静脉取除癌栓不增加手术的创伤和难度,其治疗效果与无癌栓肝癌的手术疗效相近。 相似文献
7.
彩色多普勒观察门静脉癌栓及肝硬化对原发性肝癌血供的影响 总被引:4,自引:0,他引:4
目的:探讨门静脉癌栓及肝硬化对肿瘤血供的影响。方法:本研究回顾性分析108例原发性肝癌的彩色多普勒超声图像,所有病例分为三组。Ⅰ组:单纯性肝癌,54例;Ⅱ组:肝癌合并门静脉癌栓,27例;Ⅲ组:肝癌合并肝硬化,27例。结果:肿瘤动脉收缩期峰值流速(PSV)均值以Ⅱ组最高,阻力指数(RI)均值以Ⅲ组最高。当肿瘤≤10cm时,各组间PSV、RI均值差异具显著性(p<0.01~0.05)。结论:门静脉癌栓及肝硬化对肝癌动脉PSV和RI具有一定影响。 相似文献
8.
脉冲多普勒超声对29例肝癌合并门脉瘤栓患者肝动脉血流测定 总被引:3,自引:1,他引:3
本文应用超声多普勒对36例原发性肝癌,29例原发性肝癌合并门脉瘤栓及20例正常人的肝总动脉内径及最大血流速度进行测定,结果示:肝总动脉内径:正常人0.387±0.07cm,原发性肝癌0.525±0.02cm,合并门脉瘤栓0.706±0.06cm。最大血流速度;正常人91.05±24.89cm/s,原发性肝癌159.25±42cm/s,合并门脉瘤栓者203.66±61.26cm/s。统计学处理,差别显著(P<0.01)。提示原发性肝癌合并门脉瘤栓时,由于门静脉血流受阻,肝动脉血流量明显代偿性增强。 相似文献
9.
肝癌伴门静脉癌栓血流动力学变化及CT表现的研究 总被引:3,自引:0,他引:3
目的:探讨肝癌门静脉癌栓时肝脏血流动力学改变及其影像特征,为肝癌的诊治和预后判断提供帮助。材料和方法:经临床证实并行全肝螺旋CT双期增强扫描的原发性肝癌伴门静脉癌栓32例,不伴门静脉癌栓54例,分别观察动脉期和门脉期癌旁与较远处肝实质及肝癌结节的密度变化。结果:18例肝癌伴门静脉分支癌栓,动脉期主要表现肝动脉血流高灌注,相应受累肝实质呈现斑片状、弧圈形或楔形高密度影,门脉期也见少许楔形高密度影;14例主门静脉主干癌栓和54例门静脉无癌栓,绝大多数全肝密度均匀一致;门静脉有无癌栓组间,灌注异常出现率不同;门静脉癌栓时肝癌的血供分型发生变化,门脉供血型和双重供血型明显减少。结论:肝癌伴门静脉癌栓可影响肝脏的血流动力学改变,引起肝癌结节和周围非癌肝实质的灌注异常,产生特征性的CT表现。 相似文献
10.
探讨彩色多普勒超声诊断原发性肝癌并门静脉癌栓的临床特点。回顾性分析43例原发性肝癌并门静脉癌栓患者的彩色多普勒超声检查资料,并与30例健康人的超声检查结果进行对比。单个结节型肝癌5例、多个结节型肝癌21例、块状型肝癌10例、弥漫型肝癌7例;43例门静脉主干内径显著高于正常对照组(P0.05);43例肝静脉主干内径及血流速度均显著高于正常对照组(P0.05)。运用彩色多普勒超声能够较为准确地诊断原发性肝癌并门静脉癌栓,较为准确地显示门静脉及肝动脉血流动力学的变化情况,值得临床广泛使用。 相似文献
11.
We describe two cases of thrombosed extrahepatic portal vein aneurysms diagnosed by sonography, computed tomography, and magnetic
resonance imaging. Portal vein aneurysm is a rare clinical entity that has been described as a focal dilatation that can affect
intra- and extrahepatic portal branches. Although usually asymptomatic, thrombosis can lead to portal hypertension. Clinical
and imaging characteristics are discussed, in addition to a review of the literature. 相似文献
12.
Portal vein aneurysm is a rare clinical entity, with only 41 published cases in the English-language literature. Twenty-five
of them were congenital. We present the case of a 50-year-old woman who was incidentally diagnosed with a congenital extrahepatic
portal vein aneurysm during an investigation for dyspepsia. Ultrasonographic features are described with correlation of computed
tomographic and magnetic resonance findings. Etiology, clinical significance, and management strategies for these lesions
are discussed and a review of the literature regarding this entity is presented. 相似文献
13.
14.
Only scattered reports of portal vein and superior mesenteric vein aneurysms appear in the literature. Case reports of three
patients with portal vein and superior mesenteric vein aneurysms diagnosed by computed tomography (CT) and gray-scale, color
Doppler, and duplex Doppler sonography are presented. In one case, an isolated portal vein aneurysm was demonstrated. In the
second case, an aneurysm of the portal vein and superior mesenteric vein resulting in biliary ductal dilatation was observed.
In the third case, an isolated superior mesenteric vein aneurysm was found. None of the patients had a history or clinical
evidence of underlying liver disease, pancreatitis, or other disease states that would predispose them to the development
of aneurysms. The clinical presentations, possible etiologies, and imaging features of portal vein and superior mesenteric
vein aneurysms are reviewed. The value of CT and sonography in the detection and characterization of these rare aneurysms
is discussed.
Received: 29 February 1996/Accepted: 10 April 1996 相似文献
15.
《临床超声医学杂志》2015,(7)
目的探讨超声引导下经皮穿刺治疗原发性肝癌合并门静脉癌栓的疗效。方法 31例肝门静脉癌栓患者经超声引导注射无水乙醇和羟喜树碱,每2~3周注射1次,连续治疗3~5次为一个疗程,每个疗程结束后随访1~2个月。结果根据癌栓对门静脉阻塞程度的不同,31例患者分为3级:1级11例,2级15例,3级5例。治疗后22例患者癌栓缩小,总有效率为70.9%。31例患者中25例死亡,平均生存期(6.9±3.3)个月,所有患者均未发现新的肿瘤病灶;无一例发生门静脉周围药物渗出、出血、感染等严重并发症,患者腹胀减轻,腹水减少。结论超声引导下经皮穿刺门静脉癌栓注射无水乙醇和羟喜树碱是治疗门静脉癌栓的一种有效方法。 相似文献
16.
Congenital absence of the portal vein 总被引:1,自引:0,他引:1
Yujiro Matsuoka M.D. Kuni Ohtomo Toshiyuki Okubo Junichi Nishikawa Tetsuya Mine Shinya Ohno 《Abdominal imaging》1992,17(1):31-33
Absence of the terminal portion of the portal vein and its intrahepatic branches was demonstrated in a 22-year-old woman with focal nodular hyperplasia (FNH) of the liver. Various imaging studies and angiography showed that the portal vein entered into the inferior vena cava just above the renal veins. The clinical and radiological features of this patient and nine previously reported cases of this entity are herein reviewed. 相似文献
17.
Portal vein aneurysm is an unusual vascular abnormality. We report a rare case of a huge intrahepatic portal vein aneurysm at the umbilical portion with hepatic encephalopathy. Abdominal contrast-enhanced dynamic computed tomography and angiography clearly showed a well-circumscribed, 50 x 40-mm portal vein aneurysm at the umbilical portion with portohepatic venous shunt. To our knowledge, this is the largest intrahepatic portal vein aneurysm ever reported. 相似文献
18.
19.
Hepatic actinomycosis with portal vein occlusion 总被引:1,自引:0,他引:1
Yu Fan Cheng M.D. Chien Fu Hung Yang Han Liu Koon Kwan Ng Chung Chueng Tsai 《Abdominal imaging》1989,14(1):268-270
Hepatic actinomycosis with abdominal wall invasion was found by computed tomography (CT) in a 44-year-old woman. Occlusion of the main and right portal veins by the actinomycoma causing cavernous transformation was proven by angiography. Duodenobiliary reflux and communication between the biliary tree and the abscess were demonstrated by upper gastrointestinal radiography, percutaneous transhepatic cholangiogram, and CT. The imaging studies reflected the pathologic process of this disease. The unique feature of this case is that infection ascended through the duodenobiliary reflux; this should be considered one of the routes for the transmission of hepatic actinomycosis. 相似文献