骶正中动脉造影及栓塞在骶骨肿瘤切除术中的价值

Clinical significance of selective middle sacral artery angiography and embolization in sacral tumors resection

目的探讨骶正中动脉在骶骨肿瘤术前栓塞及治疗中的作用。方法对63例骶骨肿瘤患者常规行X线平片,CT和(或)MR检查,术前均行双侧髂内动脉和(或)腰动脉、骶正中动脉造影,并超选择插管栓塞肿瘤供血动脉。结果63例骶骨肿瘤中,肿瘤表现为富血供者37例,乏血供者26例。富血供者37例中,骶正中动脉参与供血者22例,表现为血管增粗、增多、纡曲、肿瘤染色。术前栓塞后,61例手术效果满意,不满意2例。结论骶正中动脉在骶骨肿瘤术前栓塞治疗中具有重要意义。对骶骨肿瘤,术前栓塞除常规髂内动脉栓塞外,应考虑到有骶正中动脉等多支供血的特点,尽量栓塞彻底以减少术中出血。

Objective To explore the value of middle sacral artery embolization（MSA）in the surgical treatment of sacral tumors.Methods Selective angiography and embolization of the tumor feeding vessels were performed before operation in 63 patients with sacral tumors diagnosed by X-ray plain film,CT and MR.The targeting arteries of embolization included bilateral internal iliac,lumbar artery,and possiblely MSA.Results Thirty-seven sacral tumors were revealed with hypervascular supply,among which blood supply from MAS in addition to illiac arteries and lumbar artery were found in 22 tumors.Successful embolization of both internal iliac artery,lumbar artery and MSA was performed,and then satisfactory surgical operation was achieved in 20 of these 22 patients.Conclusion Embolization of MSA is important before surgical resection of sacral tumors.Sufficient emboliazation of existing tumor feeding arteries should be performed in the treatment of sacral tumors,especially of hypervascular tumors.