肝癌侧支循环的DSA分析

DSA Analysis of collateral circulation in hepatic maglignancies

目的 :分析肝癌侧支循环的DSA表现。方法 :对 35例肝癌患者进行选择性腹腔动脉或肝动脉造影 ,其中 5例单纯行肝动脉灌注化疗 ,30例以碘油抗癌乳剂及明胶海绵进行栓塞。结果 :①肝内侧支 15例 ,其中叶内侧支 10例 ,叶间侧支 5例。②肝外侧支 2 4例 ,其中膈下动脉 7例 ,肠系膜上动脉 4例 ,胰十二指肠动脉弓 3例 ,胃左动脉 3例 ,肝固有动脉 3例 ,胃十二指肠动脉 2例 ,胃网膜右动脉及右肾动脉各 1例。结论 :①侧支循环形成是导致肿瘤复发的重要因素 ,为进一步栓塞治疗带来困难。

Purpose:DSA findings of collateral circulation of hepatic maglignancies were studied. Methods:35 patients with hepatic maglignancies were performed by selective celiac or hepatic arteriography. 5 patients were treated by intra arterical chemotherapy and 30 patients by embolization with lipiodol anticarcinogen emulsion and gelfoam.Results:①Intrahepatic collaterals were seen in 15 cases, of which 10 were intralobar collaterals and 5 were interlobar collaterals. ②Extrahepatic collaterals were found in 24 cases, which include: In ferior phrenic artery in 7, superiorior mesentric artery in 4, pancreaticoduodenal artery in 3, left gestric artery in 3, hepatic artery proper in 3, gastroduodenal artery in 2, gastroepiploic artery in 1 and right renal artery in 1. Conclusions:①Collateral circulation can play an important role in recurrence of hepatic maglignancies. Futher treatment by infusion or embolization through these collaterals is technically much more difficult. ②It will be more effective on treating hepatic maglignancies to embolie collateral circulation.