暂时阻断肝静脉后肝脏的血流改变及其意义:CT影像学研究

Alteration of the Hepatic Circulation after Temporary Occlusion of the Hepatic Vein: An Experimental Study in Dog with Spiral CT

目的 研究犬肝静脉阻断后肝脏血流改变 ,并评估该技术在肝癌介入治疗中的应用价值。材料与方法 对 6只犬行肝静脉球囊导管阻断 ,应用螺旋CT行肝脏双期扫描和同层动态增强扫描。结果 肝静脉受阻肝叶密度明显低于未阻肝叶 ,二者形成明显的分界 ,门静脉逆行增强显影 ;受阻肝叶肝实质及门静脉增强的平均峰值时间明显滞后于未受阻者。结论 暂时阻断肝静脉后受阻区域总的血流量减少 ,血流速度变缓 ,门静脉变为引流静脉。暂时阻断肝静脉行肝动脉化疗栓塞术和局部高温固化疗法是一项有临床应用前景的技术。

Objective To assess the hemodynamic alteration of the dog liver after temporary occlusion of the hepatic vein, and to evaluate this technique in the interventional treatment of liver neoplasm.Materials and Methods The selected hepatic veins were temporarily occluded with a balloon catheter in 6 dogs. Spiral CT scanning of the liver, including dual phase scanning and same level enhanced dynamic scanning, was performed before and after temporary occlusion of a hepatic vein.Results The hepatic parenchyma density of the occluded area was much lower than that of non occluded area with a clear line of demarcation between the two areas. Retrograde opacification of the portal vein in the occluded area was seen. The peak time of enhancement for the hepatic parenchyma and for the main portal trunk in the occluded area was obviously delayed when compared with that in the non occluded area.Conclusion After hepatic vein is occluded, the blood flow in the occluded area will be reduced and slowed down, and the portal veins in this area become the draining vessels. The results suggest that temporary occlusion of the hepatic vein may be an effective and promising technique in performing hepatic chemoembolization therapy and thermotherapy for the liver neoplasm.