肝动脉解剖变异在肝癌介入治疗中的临床意义

Clinical significance of anatomical variation of hepatic artery in interventional therapy for HCC

目的探讨肝动脉解剖变异的DSA表现及其在肝癌肝动脉栓塞化疗(TACE)中的临床意义。方法回顾分析223例肝癌患者的DSA资料,对存在解剖变异的肝动脉进一步分析其起源、走行、分布及对TACE的影响,统计每组变异肝动脉的发生率。结果223例中,32例存在肝动脉解剖变异,占14.34%,共40支变异肝动脉,其中变异肝总动脉2支(5%,2/40),变异肝固有动脉1支(2.5%,1/40),变异肝右动脉24支(60%,24/40),变异肝左动脉13支(32.5,13/40),有30支变异肝动脉直接参与肿瘤供血,其中24支行TACE治疗,6支行肝动脉化疗(TAI)。结论正确认识肝动脉的解剖变异特征对提高TACE的成功率、降低手术风险有极其重要的意义。

Objective To study DSA characteristics of anatomic variantion of hepatic artery and its clinical significance in TACE. Methods DSA manifestations in 223 cases of hepatic cancer were analyzed retrospectively. Origin and course and distribution of anatomic variantion of hepatic artery as well as influence on TACE were further analyzed. The frequency of each group variant hepatic artery was summed up. Results Of 223 cases, variant hepatic arteries were found in 32 cases （14.34%）, There were 2 variant common hepatic arteries （7.5%） and 1 variant proper hepatic artery （2.5%） and 24 variant right hepatic arteries （60 %） and 13 variant left hepatic arteries （32.5 %） of the total 40 variant hepatic arteries. 30 AbHAs participated feeding liver cancer directly,treatment by TACE through 23 variant hepatic arteries and therapy by TAI through 7 variant hepatic arteries. Conclusion It is very important understanding anatomic characteristics of variant hepatic arteries for improving success rate of TACE and preventing its risk.