当代医学
噹代醫學
당대의학
CHINA CONTEMPORARY MEDICINE
2013年
18期
6-8
,共3页
肝癌%动静脉瘘%化疗栓塞%治疗性
肝癌%動靜脈瘺%化療栓塞%治療性
간암%동정맥루%화료전새%치료성
Hepatocellular carcinoma%Arterioportal fistulas%Chemoembolization%Therapeutic
目的探讨肝癌（HCC）合并肝动脉-门静脉瘘(APFs)的DSA表现和不同栓塞模式介入治疗的应用价值。方法回顾性分析38例均有APFs的HCC患者的DSA图像。所有患者均给予经肝动脉化疗栓塞（TACE）或经肝动脉灌注化疗（TAI）治疗。APFs的栓塞方式有：钢圈+明胶海绵+TACE，明胶海绵+TACE，TAI。结果 APFs的DSA表现可分为中央型和周围型。中央型（29例）表现为门静脉主干及大分支提前显影和（或）肿瘤染色出现于门静脉显影之后。周围型（9例）表现为肿瘤内出现门脉分支显影，与动脉分支伴行可呈“双轨征”。介入治疗钢圈+明胶海绵+TACE 9例，明胶海绵+TACE 25例，TAI 4例。结论 DSA是诊断肝癌合并肝动脉-门静脉瘘的直观可靠的方法，对介入治疗有指导作用。不同栓塞模式治疗APFs是安全有效的。
目的探討肝癌（HCC）閤併肝動脈-門靜脈瘺(APFs)的DSA錶現和不同栓塞模式介入治療的應用價值。方法迴顧性分析38例均有APFs的HCC患者的DSA圖像。所有患者均給予經肝動脈化療栓塞（TACE）或經肝動脈灌註化療（TAI）治療。APFs的栓塞方式有：鋼圈+明膠海綿+TACE，明膠海綿+TACE，TAI。結果 APFs的DSA錶現可分為中央型和週圍型。中央型（29例）錶現為門靜脈主榦及大分支提前顯影和（或）腫瘤染色齣現于門靜脈顯影之後。週圍型（9例）錶現為腫瘤內齣現門脈分支顯影，與動脈分支伴行可呈“雙軌徵”。介入治療鋼圈+明膠海綿+TACE 9例，明膠海綿+TACE 25例，TAI 4例。結論 DSA是診斷肝癌閤併肝動脈-門靜脈瘺的直觀可靠的方法，對介入治療有指導作用。不同栓塞模式治療APFs是安全有效的。
목적탐토간암（HCC）합병간동맥-문정맥루(APFs)적DSA표현화불동전새모식개입치료적응용개치。방법회고성분석38례균유APFs적HCC환자적DSA도상。소유환자균급여경간동맥화료전새（TACE）혹경간동맥관주화료（TAI）치료。APFs적전새방식유：강권+명효해면+TACE，명효해면+TACE，TAI。결과 APFs적DSA표현가분위중앙형화주위형。중앙형（29례）표현위문정맥주간급대분지제전현영화（혹）종류염색출현우문정맥현영지후。주위형（9례）표현위종류내출현문맥분지현영，여동맥분지반행가정“쌍궤정”。개입치료강권+명효해면+TACE 9례，명효해면+TACE 25례，TAI 4례。결론 DSA시진단간암합병간동맥-문정맥루적직관가고적방법，대개입치료유지도작용。불동전새모식치료APFs시안전유효적。
Objective To investigate of digital subtraction angiography (DSA) manifestations and the value of various interventional embolizing procedures for HCC with arterioportal fistulas(APFs). Methods Arteriography imaging data of 38 cases of hepatocellular carcinoma with arterioportal fistulas were analyzed retrospectively.All cases were undergone transcatheter arterial chemoembolization (TACE) or transcatheter arterial infusion (TAI).There were 3 methods embolizing APFs, The first method used combination of steel coils,gelfoam and TACE.Combination of gelfoam and TACE was applied in the second method.TAI was adopted in the third method. Results 29 cases of centre type which showed early visualization of the portal stem or more proximal portal branches. And 9 cases of periphery type which showed early visualization of the segmental or more distal portal branches,occasionally appeared as“double-track”sign when accompanying with an artery. combination of steel coils,gelfoam and TACE in 9 APFs, gelfoam and TACE in 25 APFs, TAI only in 4 APFs. Conclusion DSA is an accurate and direct diagnostic method for hepatocellular carcinoma with arterioportal fistulas, and this can provide important guides to the interventional treatment to the patients. Various interventional embolizing procedures is safe and effective for APFs.
