迷走肝动脉的DSA研究及临床意义

Aberrant Hepatic Artery: A Study with DSA and Its Clinical Significance

目的 研究迷走肝动脉的解剖特征 ,探讨其临床意义。资料与方法 回顾分析 10 0 0例肝动脉DSA资料 ,将直接起自腹腔干及胃肠道供血动脉的变异肝动脉称之为迷走肝动脉 (aberranthepaticartery,AbHA) ,并根据其在肝内的走行方向和分布范围不同 ,进一步将其分为迷走肝右动脉 (aberrantrighthepaticartery ,AbRHA) ,迷走肝左动脉 (aberrantlefthepaticartery ,AbLHA) ,迷走肝中动脉 (aberrantmiddlehepaticartery ,AbMHA) ,迷走肝固有动脉 (aberrantproperhepaticartery ,AbPHA)及迷走肝总动脉 (aberrantcommonhepaticartery ,AbCHA)等 ,分别统计其发生率 ,描述其起源、走行、分支、分布等解剖学特征。结果 10 0 0例中 ,共发现 2 10例存在AbHA ,占 2 1% ,其中 12例分别显示 2支AbHA ,共发现 2 2 2支AbHA ,其构成如下 :AbRHA 10 2支 (45 .95 % ,10 2 / 2 2 2 ) ,AbLHA 88支 (39.6 4 % ,88/ 2 2 2 ) ,AbMHA 4支 (1.80 % ,4 / 2 2 2 ) ,AbPHA 3支 (1.35 % ,3/ 2 2 2 ) ,AbCHA 2 5支 (11.2 6 % ,2 5 / 2 2 2 )。 2 2 2支AbHA中 ,起于肠系膜上动脉 114支 (5 1.35 % ,114 / 2 2 2 ) ,起于胃左动脉 83支 (37.39% ,83/ 2 2 2 ) ,起于胃十二指肠动脉 13支 (5 .86 % ,13/ 2 2 2 ) ,起于腹腔干 10支 (4.5 0 % ,10 /

Objective To investigate anatomic characteristics and clinical significance of aberrant hepatic artery (AbHA). Materials and Methods DSA manifestations in 1000 hepatic arteriography were retrospectively reviewed. The AbHA was defined as these liver feeding arteries which directly originated from the celiac axis or from the gastrointestinal arteries. According to their course and distribution within the liver, AbHAs were further subdivided into aberrant right (AbRHA), left (AbLHA), middle (AbMHA), proper (AbPHA) and common (AbCHA) hepatic artery. The frequency of each of them was summed up and their anatomic characteristics, such as origin, course, branches and distribution, were described. Results Of 1000 cases, AbHA was found in 210 cases (21%) with 12 cases having two AbHAs. The total 222 AbHAs included AbRHA (n=102, 45.95%), AbLHA (n=88, 39.64%), AbMHA (n=4, 1.80%), AbPHA (n=3, 1.35%) and AbCHA (n=25, 11.26%). The AbHAs was originated from superior mesenteric artery (n=114, 51.35%), left gastric artery (n=83, 37.39%), gastroduodenal artery (n=13, 5.86%), celiac axis (n=10, 4.05%) and right gastric artery (n=2, 0.90%).Conclusion AbHA is a common variation, A knowledge of this variation is very important in doing transcatheter arterial chemoembolization for the treatment of liver cancer.