超音波診斷肝細胞癌所致之下腔靜脈腫瘤栓塞

Sonographic Diagnosis of Inferior Vena Cava Tumor Thrombus in Hepatocellular Carcinoma

龍興中(Shing-Chung Long) ； 周宜宏(Yi-Hong Chou) ； 許重權(Chung-Chuan Hsu) ； 姜仁惠(Jen-Huey Chiang) ； 吳峻吉(Chun-Chin Wu) ； 張遵(Tsuen Chang)

《中華放射線醫學雜誌》 10卷3期 (1985/09) Pp. 192-198

摘要

榮民總醫院自1985年1月至1985年6月間，經實時間超音波掃描診斷為肝細胞癌(HCC)者有72例，其中53例以病理、生檢、細胞學及臨床實驗室資料證實為HCC，在這53例中8例合併有下腔靜脈腫瘤栓塞(IVCT)，8例皆為男性，平均為60歲，皆合併有硬化。本文將這8例圖像分析，發現一例為瀰漫性結節型，其餘為單一腫瘤質塊。3例為高回音強度，5例為低回音強度，而且HCC的回音強度和IVCT的回音強度一致。HCC位於或侵及肝右葉後段者易造成IVCT，HCC的大小，愈大者似乎愈易出現IVCT。杜卜勒超音波可以有效的證實IVCT的存在。

並列摘要

From Jan. 1985 to Jun. 1985, 75 patients were diagnosed as hepatotcellular carcinoma (HCC) by using real-time ultrasound in Departmentof Radiology, Veterans General Hospital. 53 of them were subsequently proved by pathology, biopsy, cytology and/or sufficient laboratory data. Among these 53 patients, 8 patients had been found to have inferior vena cava thrombus (IVCT). All the 8 patients were male, the age averaged 60, and all were associated with cirrhosis of liver.
Reviewing the sonograms in these 8 patients, one was found to be diffuse nodular type and the others were solitary massive type. The echo pattern of the primary hepatic lesion is hyperechoic in 3 and hypoechoic in 5, and the echo pattern between the HCC and IVCT were accordant. The thrombus in the certain segment of IVC would distend its lumen. The HCC located or involved the posterior segment of right hepatic lobe is prone to have IVCT. The larger the size of HCC, the more frequent presence the IVCT. The Doppler ultrasound can confirm the existence of IVCT.