肝海绵状血管瘤血供来源研究方法的讨论

DISCUSSION OF STUDY METHODS IN THE BLOOD SUPPLY OF LIVER CARVENOUS HEMANGIOMA

目的 探讨肝海绵状血管瘤血供来源及研究方法的科学性。方法 对 5例病人 ,经肝右动脉支结扎后 ,分别行门静脉连续造影和注入亚甲兰肝染色 ,观察门静脉与瘤体关系 ;对 2 2例肝动脉支插管造影 ;2例切除肝叶经静脉行血管铸型标本观察。结果 门静脉造影在门静脉期 ,门静脉支被瘤体推移 ,造影剂不进入瘤内 ;肝实质期 ,瘤体区形成低密度区。亚甲兰染色 ,仅见肝实质染色 ,瘤区不被染色 ,界限分明。血管铸型标本见瘤体完全腐蚀脱落、无静脉支伸入。结论 CHL由肝动脉供血 ,未见门静脉供血 。

Objective To investigate the source of blood supply of carvenous hemangioma of Liver(CHL)and the feasibility of study methods.Methods Serial portovenography and portal vein stain with methylene blue were performed in 5 patients after their right hepatic artery was ligated.The relation between portal vein and tumor was observed.Hepatic arterography was porformed in 22 patients,2 specimens of resected hepatic lobe via veins were observed.Results In 5 cases with portography,the contrast medium could not enter the tumor.In the intrahepatic branches of parenchymal phase,the tumor appeared to be of low density area.After the injection of methylene blue through portal vein,only the normal liver parenchyma was stained,but the tumor was not stained.The boundary was sharp.The specimens showed that the eroded tumor left behind a round vacant area in the specimens.No branches of portal vein was found to extended into the tumor.Conclusion The blood supply of CHL originates from the hepatic artery,not from the portal vein.The feasibility of study methods is discussed.