Kaneko T, Nakao A, Inoue S, Funahashi H, Harada A, Nonami T, Takagi H
Department of Surgery II, Faculty of Medicine, Nagoya University, Japan.
Surgery. 1995 May;117(5):538-44. doi: 10.1016/s0039-6060(05)80253-3.
We evaluated the role of intravascular ultrasonography in the diagnosis of intravascular tumor thrombi.
During the past 2 years intracaval endovascular ultrasonography was performed in 26 selected patients to diagnose inferior vena cava invasion. Results of positive intracaval endovascular ultrasonogram were correlated with the pathologic findings of resected specimens and autopsy and with other imaging technologies such as computed tomography and angiography.
Six patients had positive studies of intracaval tumor thrombus. In all cases detailed horizontal images perpendicular to the inferior vena cava axis were studied. Five of the six patients underwent resection. Intravascular ultrasonography correctly predicted the extent of the tumor thrombus, the degree of tumor adherence to the vessel wall, and the intraluminal movement of the tumor thrombus. Floating thrombi were visualized as an intraluminal to-and-fro movement. Thrombus adhesion to the vessel wall appeared as an absence of space between the tumor and the wall, with no respiratory movement of the thrombus.
Intravascular ultrasonography was useful for the accurate diagnosis of intravascular tumor thrombi and aided in formulating the operative strategy.
我们评估了血管内超声检查在诊断血管内肿瘤血栓中的作用。
在过去2年中，对26例选定患者进行了腔静脉内血管超声检查以诊断下腔静脉侵犯。腔内血管超声检查阳性结果与切除标本和尸检的病理结果以及计算机断层扫描和血管造影等其他成像技术进行了相关性分析。
6例患者腔内肿瘤血栓检查呈阳性。在所有病例中，均研究了垂直于下腔静脉轴的详细水平图像。6例患者中有5例接受了切除术。血管内超声检查正确预测了肿瘤血栓的范围、肿瘤与血管壁的粘连程度以及肿瘤血栓在管腔内的移动情况。漂浮血栓表现为管腔内的来回移动。血栓与血管壁的粘连表现为肿瘤与血管壁之间无间隙，且血栓无呼吸运动。
血管内超声检查有助于准确诊断血管内肿瘤血栓，并有助于制定手术策略。
