肺癌动脉介入治疗的多靶血管分析  

Analysis of multiple arteries supply to pulmonary carcinoma with interventional therapy

作　　者：江森[1] 朱晓华[1] 孙兮文[1] 支文祥[1] 马骏[1] 尤正千[1] 虞栋[1] 

机构地区：[1]上海市肺科医院影像科,200433

出　　处：《上海医学影像》2005年第1期33-35,共3页Shanghai Medical Imaging

摘　　要：目的回顾分析肺癌动脉介入治疗中的多支供血动脉情况及特点。方法收集我院肺癌动脉介入治疗中发现存在多靶血管情况的51例病例,并对此组病例结合其临床、影像资料及治疗情况,对血管造影图像进行回顾性分析研究。结果51例多靶动脉供血的肺癌患者中(2支者45例,3支者3例,4支者3例),支气管动脉、肋间动脉、锁骨下动脉各分支、心包动脉等均可参与肺癌的供血,而且供血有一定特点:多支支气管动脉均对肿瘤及淋巴结供血者中,中央型肺癌比例较高;周围型肺癌存在患侧支气管动脉对肿瘤及部分淋巴结供血而对侧支气管动脉提供部分纵隔及对侧肺门淋巴结血供的情况;肋间动脉参与肿瘤供血以中央型肺癌为多;锁骨下动脉属支参与肺癌供血者中多为上叶病灶,其中以胸廓内动脉参与机率最高,这其中多为中央型肺癌;心包动脉及心包膈动脉可参与下叶肺癌的供血;肺癌伴肺内转移患者中,有相当一部分存在对原发灶及肺内转移灶多动脉供血;在行支气管动脉灌注及栓塞治疗后可形成新生供血动脉,特别在栓塞治疗后。结论肺癌的体循环介入中可呈多靶动脉性,并具一定特点。肺癌的动脉介入治疗应尽量找到所有供血血管,以完善治疗效果。Objective To retrospectively analyze the characteristic of multiple arteries supply to pulmonary carcinoma with interventional therapy. Methods 51 cases of angiography were retrospectively studied combining with their clinical, image and treatment information which cases revealed in interventional therapy all had multiple arteries supply to pulmonary carcinoma. Results Angiography images demonstrated: two arteries (n=45), three arteries (n=3) and four arteries (n=3). These arteries included: bronchial artery, intercostal artery, etc. These arterial supply had its characteristic. Central bronchogenic carcinoma had its high proportion in cases with multiple bronchial artery supply to tumor and lymph node. Peripheral bronchogenic carcinoma had in cases with affected side's bronchial artery supply to tumor and lymph nodes while contralateral bronchial artery supply to ipsilateral lymph node. Intercostal artery supply to tumor most in central bronchogenic carcinoma. Subclavian artery supply to tumor most in superior lobe, but pericardial artery and pericardiacophrenic artery supply to tumor most in inferior lobe. Many cases with pulmonary carcinoma companion with metastasis within lung had multiple arteries supply, new artery formed after bronchial artery infusion and embolization of tumor. Conclusion It is clear that pulmonary carcinoma had multiple arteries supplying and typical characteristic. To get better effect of interventional therapy, all arteries supply to pulmonary carcinoma should be found to the limit.

关 键 词：中央型肺癌 动脉介入 动脉供血 支气管动脉 靶血管 肿瘤 治疗中 心包 供血动脉 锁骨下动脉 

分 类 号：R734.2[医药卫生—肿瘤] R737.310.5[医药卫生—临床医学]