[DSA manifestation of primary hepatocellular carcinoma complicated by tumor thrombus in the inferior vena cava].

Abstract

To study the manifestations of the primary hepatocellular carcinoma (PHC) complicated by tumor thrombus (TT) in the inferior vena cava (IVC) in digital subtraction angiography (DSA) and to understand their clinical implications.
A retrospective study of the hepatic arterial angiography, the inferior vena cavography and the interventional treatment in 8 cases of PHC patients was conducted.
Hepatic arterial-venous shunt, tumor thrombus in the hepatic veins and filling defect in the IVC were identified in 6 patients. The IVC TT presented obvious "strip signs" in DSA images. In 4 patients TT in the right atrium (RA) was found in connection with the IVC TT. Scattered lipiodol deposits were observed in the IVC TT, which decreased in volume in 4 patients after hepatic arterial chemoembolization. Five patients with TT in the IVC and blood backflow blockage received IVC stent implantation for alleviation of the symptoms.
The blood supply of TT in IVC is derived from the hepatic artery, and computed tomography, magnetic resonance imaging and DSA all have superior diagnostic value for such TT. Transcatheter hepatic arterial chemoembolization and IVC stent implantation may constitute effective treatment modalities for PHC complicated by TT in the IVC.