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Background. We evaluated the role of intravascular ultrasonography in the diagnosis of intravascular
tumor thrombi.
Methods. 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.
Results. 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.
Conclusions. Intravascular ultrasonography was useful for the accurate diagnosis of intravascular
tumor thrombi and aided in formulating the operative strategy.
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Article info
Publication history
Accepted:
September 26,
1994
Identification
Copyright
© 1995 Mosby-Year Book, Inc. Published by Elsevier Inc.
