Imaging findings and transcatheter arterial chemoembolization of hepatic malignancy with right atrial embolus in 46 patients.
OBJECTIVE
To analyze the imaging findings of hepatic malignancy with right atrial (RA) embolus.


METHODS
Forty-six patients with an embolus in the RA were diagnosed, including 44 patients with hepatocellular carcinoma (HCC), 1 patient with cholangiocellular carcinoma and 1 patient with hepatic carcinoma metastasis. The diagnosis was confirmed by clinical examination, serum alpha-fetoprotein and imaging. Seventeen patients underwent transcatheter arterial chemoembolization (TACE).


RESULTS
On enhancement computer tomography (CT) or magnetic resonance (MR) imaging, a nodular filling defect in the RA could be easily found, with a slight enhancement in the arterial phase. The coronal images of CT or MR showed the extent of lesion. Lipiodol entered the embolus after TACE, hence reducing the speed of embolus growth. There was a survival benefit for patients receiving anticancer treatment.


CONCLUSIONS
Patients with HCC, showing a filling defect of the inferior vena cava (IVC), hepatic vein (HV) and RA on images, can be diagnosed with RA embolus. Encroachment of the RA is very rare in patients with hepatic malignancies. Furthermore, a prolongation of survival time is found in those patients who underwent TACE.
Cheng
Hong-Yan
HY
Department of Radiology, Eastern hepatobiliary Surgery Hospital, 225 Changhai Road, Shanghai 200438, China. chengys9304@yahoo.com.cn
Wang
Xiao-Yan
XY
Zhao
Guo-Li
GL
Chen
Dong
D
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000473:pathology* / Q000532:radiotherapy / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000473:pathology; D006338:Heart Neoplasms / Q000556:secondary / Q000628:therapy*; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome