Goldfarb D A, Novick A C, Lorig R, Bretan P N, Montie J E, Pontes J E, Streem S B, Siegel S W
Department of Urology, Cleveland Clinic Foundation, Ohio 44106.
J Urol. 1990 Nov;144(5):1100-3; discussion 1103-4. doi: 10.1016/s0022-5347(17)39668-4.
We assessed the accuracy of magnetic resonance imaging in demonstrating the presence and extent of vena caval tumor thrombi. The study group included 20 patients with vena caval thrombi from renal cell carcinoma (18), renal pelvic transitional cell carcinoma (1) and adrenal pheochromocytoma (1). Preoperative diagnostic studies included magnetic resonance imaging in all patients, inferior venacavography in 16 and computerized tomography scanning in 15. All patients underwent an operation in which the presence and extent of the vena caval thrombus were confirmed. Magnetic resonance imaging accurately delineated the presence and extent of the thrombus in all 20 patients (100%). Venacavography was accurate in 15 patients (94%) but 8 (50%) required a retrograde and antegrade study. Computerized tomography scanning demonstrated the presence of a tumor thrombus in all 15 patients but accurately delineated the cephalad extent of the thrombus in only 5 (33%). In patients with vena caval tumor thrombi magnetic resonance imaging can provide accurate information regarding the extent of vena caval involvement while avoiding the need for an invasive contrast imaging study.
我们评估了磁共振成像在显示腔静脉肿瘤血栓的存在及范围方面的准确性。研究组包括20例患有腔静脉血栓的患者，其中血栓源于肾细胞癌（18例）、肾盂移行细胞癌（1例）和肾上腺嗜铬细胞瘤（1例）。术前诊断性检查包括所有患者均行磁共振成像，16例行下腔静脉造影，15例行计算机断层扫描。所有患者均接受了手术，术中证实了腔静脉血栓的存在及范围。磁共振成像在所有20例患者（100%）中均准确描绘了血栓的存在及范围。下腔静脉造影在15例患者（94%）中结果准确，但8例（50%）需要逆行和顺行检查。计算机断层扫描在所有15例患者中均显示存在肿瘤血栓，但仅在5例（33%）中准确描绘了血栓的头端范围。对于患有腔静脉肿瘤血栓的患者，磁共振成像可提供有关腔静脉受累范围的准确信息，同时无需进行侵入性造影成像检查。
