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Imaging Features and Chemoembolization of Hepatocellular Carcinoma with Tumor Thrombus in Portal Vein

Shi Haibin, Feng Yaolian, Wang Jie, et al. Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029  
Objective: Evaluate imaging features and methods of transcatheter hepatic artery chemoembolization (TACE) of hepatocellular carcinoma (HCC) with portal tumor thrombus (PTT).Materials and Methods:TACE was performed in 28 patients with HCCs accompanied by PTT. The primary tumors and the PTT were detected with ultrasonography (US), CT and digital subtraction angiography (DSA) before TACE. The detection rate was compared with each other. 56 cases of HCC without [CM PTT was taken as control group. Results:The portal vein was clearly showed and the PTT was found in 24 among 28 cases (85.7%) by DSA. The detection rate by US was 76%, by CT 38.5%. 35.7% of 28 patients with PTT had the primary tumor mainly in the internal left lobe of liver, 17.9% in both right and left lobes, but in control group without PTT 7.2% and 10.7%, respectively ([WT5”BX〗P0.01). The size of the primary tumor in patient whose tumor was mainly in the internal left lobe was significantly smaller than that in the right lobe (P0.01). No serious dysfunction of liver due to the treatment were recognized.Conclusion: Detection of US and angiography for PTT was sensitive. Tumor in the internal left lobe of liver easily invaded the portal vein. TACE should actively be performed although the portal vein was involved by tumor.
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