原发性肝癌肝外侧支动脉供血的诊断及介入治疗

Imaging findings and interventional therapy of the hepatocellular carcinoma with collateral blood flow

目的:探讨肝癌侧支供血的影像学类型和介入治疗方法。方法:分析165例肝癌患者的数字减影血管造影(DSA)表现,并与多层螺旋CT对照。分析侧支供血类型,并相应行栓塞治疗。结果:165例肝癌侧支供血的患者DSA检查共发现侧支206条,其中右膈下动脉107条,左膈下动脉31条,右肋间动脉19条,胃十二指肠动脉13条,胃左动脉7条,右肾上腺动脉18条,胸廓内动脉11条。术前多层螺旋CT检查发现157条肝外侧支供血动脉,阳性率为76%(157/206)。栓塞侧支动脉后,行CT复查可见肿瘤病灶内碘油沉积较前密实、均匀,其边缘与肿瘤边缘相吻合。结论:肝癌的肝外侧支供血发生率较高,及时发现并进行栓塞治疗,可明显提高对肝癌的治疗效果。

OBJECTIVE：To investigate the imaging typology and intervention therapy of hepatocellular carcinoma with collateral blood flow.METHODS： Digital subtraction angiography（DSA） and helical CT imaging findings of 165 cases of hepatocellular carcinoma were reviewed for the typology of collateral blood supply of hepatocellular carcinoma and corresponding interventional therapies were proposed.RESUTLS： Two hundred and six collateral blood supply were found in 165 cases： 107 right inferior phrenic arteries,31 left inferior phrenic arteries,19 intercostal arteries,13 gastroduodenal arteries,7 left gastric arteries,18 left suprarenal arteries,11 internal thoracic arteries.76%（157/206） collateral supply were found in pre-operation helical CT imaging.All patients underwent CT scanning after embolizition,it was found that lipidol deposited more evenly and intensively and fit liver lesions better.CONCLUSION： Collateral supply are often found in hepatocellular carcinoma,while as long as it embolized the collateral supply effectively,it can be made possible for further treatment.