影像介入在腹膜后肿瘤诊疗中的应用

Application of interventional radiology in the diagnosis and treatment of retroperitoneal tumor

腹膜后肿瘤是原发于腹膜后间隙的非器官来源的恶性及良性肿瘤。腹膜后肿瘤往往体积巨大且常侵犯周围脏器和大血管,使手术切除困难。目前,对腹膜后肿瘤介入诊疗主要包括:(1)通过血管造影术了解肿瘤的血液供应来源、侵犯血管情况。(2)外科术前对富血供肿瘤进行栓塞,以减少术中出血、减少手术切除难度、减少手术并发症。(3)腹膜后肿瘤切除常需进行血管移植、重建,术后移植血管狭窄时须进行球囊扩张成形术。(4)肿瘤破裂出血、危及生命时,可进行急诊栓塞止血治疗。(5)对无法手术的腹膜后肿瘤,在影像引导下经皮射频消融可以减轻瘤负荷,缓解临床症状。

Primary retroperitoneal tumor is a diverse group of benign and malignant tumors that arise within the retroperitoneum but outside the major organs. Because retroperitoneal tumors are often enormous and close to critical retroperitoneal structures and organs, the complete resection is difficult and the incidence of perioperative complications is high. The interventional radiologists have worked several aspects as follows： angiography is used to identify the vascellum around tumor; preoperative angioembolization of tumor can minimize intraoperative blood loss and selective arterial embolization is effective in preventing hemorrhagic complications of retroperitoneal benign tumors; vasotransplantation and reconstitution are often performed after the resection of retroperitoneal tumor, percutaneousballoon angioplasty is used to resolve the stenosis of major abdominal vascular graft; embolization and haemostasis in emergency should be performed when tumor break or bleed threating to life; imaging-guided percutaneous radiofrequency ablation has been used for treatment of unresectable retroperitoneal tumor to relieve the clinical symptoms.