Kolb M, Guhl L, Arlart I P
Radiologisches Institut, Katharinenhospital Stuttgart.
Aktuelle Radiol. 1995 Nov;5(6):356-9.
In rare cases, large adrenal masses with a suspicion of malignancy exhibit tumor extension into the adrenal vein and inferior vena cava. When planning surgery, the relationship of the extension to the inferior vena cava is of decisive importance. We describe in two cases on the detection of a tumor thrombus in the inferior vena cava arising from a malignant adrenal mass by means of MR angiography (TOF, coronary 2D GRE images [FLASH], 3 slices acquired during 15 second apnea). The angiograms correlated well with the results of DSA venacavography and with the intraoperative findings. Thus, MRA has been demonstrated to be suitable for the certain proof of a venous tumor thrombus not only in cases of renal cell carcinomas but also in cases of malignant adrenal masses. The method should be applied whenever there is evidence of a venous involvement in the adrenal MR images.
在罕见情况下，怀疑为恶性的肾上腺大肿块会出现肿瘤延伸至肾上腺静脉和下腔静脉。在规划手术时，肿瘤延伸与下腔静脉的关系至关重要。我们通过磁共振血管造影（TOF、冠状动脉二维梯度回波图像[FLASH]，在15秒屏气期间采集3层图像）描述了两例源于恶性肾上腺肿块的下腔静脉肿瘤血栓的检测情况。血管造影与数字减影血管造影术（DSA）腔静脉造影结果及术中发现密切相关。因此，已证明磁共振血管造影（MRA）不仅适用于肾细胞癌病例，也适用于恶性肾上腺肿块病例，以明确证实静脉肿瘤血栓。只要肾上腺磁共振图像中有静脉受累的证据，就应采用该方法。
