Abstract:
Objective To explore the classification of portal vein tumor thrombus of hepatocellular carcinoma (HCC) for interventional treatment.
Methods The dynamic enhanced CT or MR imaging features of patients with portal vein tumor thrombus of HCC were analyzed. The portal vein tumor thrombus was divided into 5 types (Ⅰ-Ⅴ) for interventional treatment, including 2 subtypes of type Ⅱ, 3 subtypes of type Ⅲ, and 2 subtypes of type Ⅳ. The patients of type Ⅰ-Ⅳ combined with hepatic arterioportal fistula were classified into type Ⅴ. Then the effect of transcatheter arterial chemoembolization (TACE) combined with portal vein tumor thrombus and radioactive iodine-125 seeds strip implantation was observed.
Results All cases were classified successfully, including 10.2% type Ⅰ, 17.1% type Ⅱ, 53% type Ⅲ, 19.6% type Ⅳ, and 16.2% type Ⅴ with hepatic arterioportal fistula. The portal vein perfusion was improved in 68 cases (93.1%). The follow-up of 1-3 months after operation showed that the tumor thrombus at the site of implantation of iodine-125 particles was significantly atrophic with effective thrombus control.
Conclusions The classification of interventional therapy for HCC complicated with portal vein tumor thrombus is helpful to guide the clinical formulation of individualized interventional therapy strategy, which is worthy of promotion.
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