介入治疗肝脏巨大海绵状血管瘤

Interventional Treatment of Huge Hepatic Cavernous Hemangioma

目的 探讨肝脏巨大海绵状血管瘤 (HHCH)的介入治疗方法与疗效。材料与方法 治疗肝巨大海绵状血管瘤 14例。经导管注入超液化碘油和平阳霉素 (PYM)混合乳剂 ,最后用明胶海绵颗粒适量栓塞肿瘤周围小血管。结果 所有病例术前肝动脉造影均显示“枝上挂果 ,早出晚归”的异常血管湖样改变。术后 8例肿瘤明显缩小 ,异常血管湖消失。结论 采用超液化碘油和PYM混合剂加适量明胶海绵微粒联合栓塞是治疗肝巨大海绵状血管瘤较好的方法之一。

Objective To study the methods and effectiveness of interventional treatment for huge hepatic cavernous hemangioma (HHCH).Materials and Methods Transcatheter arterial embolization, successively with the emulsion of Lipiodol ultrafluid (10～15ml) mixed with PYM (16～32mg) and Gelfoam particles, was performed in 14 patients with HHCH.Results In all cases, preoperative hepatic angiography showed multiple abnormal vascular lakes in early arterial phase, known as the “hanging nut on a twig” sign and “early leaving but late returning” sign. After the treatment, significant decrease in tumor size and vanishing of abnormal vascular lakes were seen in 8 cases.Conclusion Hepatic arterial embolization with PYM mixed Lipiodol ultrafluid and Gelfoam particles is an effective therapy for HHCH.