肝癌并下腔静脉癌栓行肝动脉造影及栓塞的临床意义

目的探讨肝动脉造影及栓塞对肝癌合并下腔静脉癌栓的诊疗价值。方法回顾分析20例肝癌并下腔静脉癌栓的重复肝动脉造影和栓塞的影像学表现及介入治疗意义。结果l0例均在肝动脉造影及栓塞前后显示下腔静脉癌栓血管，16例在栓塞后l一3月内造影显示下腔静脉癌栓的供应血管增多，癌栓增大，其中4例累及心房。4N下腔静脉癌栓血管不显影。栓塞后癌栓内均见碘油沉积．部分癌栓缩小。结论原发性肝癌之下腔静脉癌栓由肝动脉主要供血．造影有较好的诊断价值。栓塞对癌栓有一定的治疗作用，不排除有促进癌栓生长的可能。治疗上宜采用综合治疗。

The Signifi cance of Hepatic Arteriography and Embolism for Hepatocellular Carcinoma with Inferior Vena Cave Tumor Thrombosis

Objective To evaluate the significance of hepatic arteriography and embolism for hepatocellular carcinoma（HCC） with inferior vena cave（IVC） tumor thrombosis. Methods Multiple hepatic arteriography and embolism were created in 20 cases of hepatocellular carcinoma with inferior vena cave tumor thrombosis. The imaging appearance and the significance of interventional therapy were studied retrospectively.Results The blood vessel of inferior vena cave tumor thrombosis appear in 20 cases before and after hepatic arteriography and embolism between 1- 3 months.The supplied vessel of inferior vena cave tumor thrombosis increased and the volume enlarged in 16 cases after embolism,cardiac atrium were involved in 4 cases,nonvisulization of inferior vena cave tumor thrombosis vessel in 4 cases.Lipiodol deposited in tumor thrombosis after embolism in all case. Diminution of volume in part of tumor thrombosis. Conclusion Arteriae hepatica（HA） is the chief supplied vessel of inferior vena cave tumor thrombosis in hepatocellular carcinoma.Hepatic arteriography is useful for diagnosis. Embolism is effective partly for inferior vena cave tumor thrombosis.But embolism may promote growth of tumor thrombosis.So,combined therapy should be advocated.