肝癌伴肝动静脉短路的DSA成像技术

目的 :探讨肝癌伴肝动静脉分流的DSA成像技术。方法 :收集 1997年～ 2 0 0 0年 2 40例肝癌介入治疗中的 32例肝癌伴肝动静脉短路分流 ,进行DSA成像技术研究。在充分展示肝动静脉分流通道后进行封堵 ,再行肝癌的栓塞治疗。结果 :32例肝癌伴肝动静脉瘘 ,其中 12例见明显的瘘道 ,17例见分流通道纤细 ,3例无确切的分流通道。结论 :合理注射参数、恰当体位。

A large congenital and solitary intrahepatic arterioportal fistula in an old woman

Arterioportal fistula(APF)is a rare cause of portal hypertension and may lead to death.APF can be congenital,post-traumatic,iatrogenic(transhepatic intervention or biopsy)or related to ruptured hepatic artery aneurysms.Congenital APF is a rare condition even in children.In this case report,we describe a 73-year-old woman diagnosed as APF by ultrasonography,computed tomography,and hepatic artery selective arteriography.The fistula was embolized twice but failed,and she still suffered from alimentary tract hemorrhage.Then,selective arteriography of the hepatic artery was performed again and venae coronaria ventriculi and short gastric vein were embolized.During the 2-year follow-up,the patient remained asymptomatic.We therefore argue that embolization of venae coronaria ventriculi and short gastric vein may be an effective treatment modality for intrahepatic APF with severe upper gastrointestinal bleeding.