肝门部胆管癌的血管造影表现分析

Appearance of Hilar Cholangiocarcinoma on Angiography

目的 通过总结肝门部胆管癌的血管造影表现 ,评价血管造影对胆管癌的诊断价值。方法 肝门部胆管癌患者 2 0例 ,共 3 2人次行肝动脉和间接门静脉血管造影。观察造影图像中肝总动脉、肝固有动脉、胃十二指肠动脉、肝右及肝左动脉 ,门静脉主干及其左右分支 ,肝静脉。结果 将 2 0例共 3 2人次的血管造影表现分为正常 15 .62 5 % (5 3 2 )、肿瘤染色15 .62 5 % (5 3 2 )、血管受侵 68.75 % (2 2 3 2 )三种。其中 ,以动脉血管 (18 2 2 )和门静脉 (12 2 2 )的受侵最常见。在动脉血管受侵中 (18 3 2 ) ,动脉血管狭窄的发生率最高 ,为 3 7.5 % (12 3 2 )。结论 在肝门部胆管癌的血管造影中 ,血管的不同程度受侵具有一定的特征性 ,可以作为其诊断的依据。同时 ,也为外科手术切除及临床预后的判定提供了帮助。

Objective To evaluate the value of angiography in diagnosis of hilar cholangiocarcinoma by analyzing its angiographic appearance. Methods Thirty two arteriography and arterial portography were performed in 20 patients with hilar cholangiocarcinoma.The images of common hepatic artery,right and left hepatic artery,gastroduodenal artery,portal vein and hepatic veins were interpreted by 2 experienced radiologists. Results Thirty two arteriographical and arterial portographical images were classified into three categories:normal (5/32,15.625%),tumor staining including neovasculization and minor tumor staining (5/32,15.625%),and vascular involvements (22/32,68.75%).The main characteristics of hilar cholangiocarcinoma on angiography were artery (18/22) and portal vein (12/22) involvements.The most common vascular involvement in hilar cholangiocarcinoma was arterial stenosis (12/32) in these three categories. Conclusion Vascular involvements of hilar cholangiocarcinoma on angiography are characteristics for the diagnosis,which would be helpful for determining specific therapy and evaluating the prognosis.