巨大肝血管瘤的影像学表现及栓塞治疗

Imaging characteristics of and embolization therapy for giant hepatic hemangioma

随着介入放射学的发展，经导管动脉灌注栓塞术（TAE）治疗肝血管瘤已成为成熟的治疗手段，尤其适用于不能或不适于手术切除的患者。2010年10月至2012年3月浙江大学附属第一医院采用介入栓塞治疗16例肝血管瘤患者，其方法为将导管插入腹腔动脉行动脉造影，观察肝血管瘤的造影表现，确认其供血动脉，将微导管超选至供血动脉，注入平阳霉素和超化碘油混悬液进行栓塞，直至透视观察瘤体周边碘油沉积完全。随访截止2012年9月，观察患者瘤体体积及患者症状缓解情况。所有患者术前造影动脉期即可见团块状或爆米花样染色，持续至延迟期仍可见，呈“早出晚归，树上挂果”的异常“血管湖”样改变。术后肿瘤明显缩小，患者症状缓解。经肝动脉介入栓塞治疗巨大肝血管效果明显，安全有效，可为外科手术切除之外的治疗选择。

With the development of interventional radi- ology, transcatheter arterial embolization has been the main treatment method for hepatic hemangioma, especially for patients who are not suitable to receive surgical resection. The clinical data of 16 patients with hepatic hemangioma who received inter- ventional therapy at the First Affiliated Hospital of Zhejiang Uni- versity were retrospectively analyzed, and the imaging character- istics of hepatic hemangioma and efficacy of embolization therapy were investigated. A catheter was inserted into the celiac artery for angiography in order to recognize the feeding arteries of the hepatic hemangioma. Lipiodol mixed with pingyangmycin for embolism was injected until the tumor was surrounded by them. All patients were followed up till September 2012, the tumor size and the symptoms were observed. Preoperative hepatic angiography showed multiple abnormal vascular lakes in early phase which was known as ＂early leaving but late returning, hanging nut on a twig＂ sign. After the therapy of intervention, the tumor became smaller and the condition of the patients was improved. Emboli- zation therapy is good and secure for treating giant hepatic hemangioma.