肝癌氩氦刀术后的DSA血管造影分析  

Analysis of DSA hepatoarteriography in hepatic carcinoma after endocare cryocare system treatment

作　　者：闫小纺[1] 魏崇键[1] 乔英[1] 彭辽河[1] 

机构地区：[1]解放军广州军区武汉总医院放射科导管室,430070

出　　处：《介入放射学杂志》2005年第4期385-387,共3页Journal of Interventional Radiology

摘　　要：目的了解肝癌氩氦刀(ECS)术后的DSA影象特征.方法本组对38例肝癌患者(原发性肝癌32例,转移性肝癌6例)作氩氦刀治疗,术后分别在7 d左右、30～60 d行肝动脉或超选择血管造影.结果单个冰球覆盖的病灶呈圆形或类圆形,其中＜5 cm以下的单发病灶,冰球覆盖较完全.冰球叠加覆盖的病灶形态多为不规则形.巨块型,弥漫结节状,治疗区内可见到病理血管和肿瘤染色.冰球覆盖遗漏区18个,肝动脉-静脉和肝动脉-门静脉瘘各4例,穿刺道出血5例,造影剂外溢6例.ECS治疗区域与周围组织有明显界限.ECS治疗术后并行肝动脉化疗栓塞术(TACE)治疗的病例复发率明显降低.结论①直径5 cm以下的单发病灶,ECS治疗效果满意;②直径5 cm以上的富血型肝癌病理血管对ECS不敏感;③巨块型,弥漫结节状,不规则状肝癌ECS治疗后遗漏区较多;④近肝包膜或肝门附近的病灶,ECS治疗时容易出现并发症;⑤ECS治疗术后7 d左右行TACE可提高肝癌综合治疗效果.Objective To study the DSA hepatoarteriography manifestations in hepatic carcinoma after endocare cryocare system （ECS）treatment for improving the comprehensive therapy of hepatic carcinoma. Methods Thirty eight male patients with primary liver cancer （ n = 32） and hepatic metastasis （ n = 6 ） were enrolled in this study. Common hepatic arteriography or super-selection angiography was performed in all patients after ECS treatment in 7 days and 30-60 days. Results The loci covered with ice ball were shown as round or ovoid. Single tumor less than 5 cm was covered completely, while the shape of focus covered with more ice ball showed irregularity, mass-like and diffuse nodulss with diseminated tumor vessels and tumor stains. The shortcoming of ECS included 18 missed areas, hepatic A-V shunt and hepatic A-portal V shunt in 4, bleeding in puncture tract 5, and extravasation of contrast material in 6 cases. Delineated margin existed between the frozon area and surrounding tissues. Conclusions ①ECS is effective on liver tumor Ф 〈 5 cm. ②ECS is not sensitive for hypervascular big tumor Ф 〉 5 cm. ③Tendency of missed areas in huge tumor and widespread nodes accurs after ECS. ④Complication occurs easily during ECS performance near the hepatic capsule and porta hepatis. ⑤TACE would improve comprehensive therapy effect of liver cancer about7 days after cryotherapy. （J Intervent Radiol, 2005, 14 ： 385-387）

关 键 词：肝癌 氩氦刀 肝动脉数字减影血管造影 原发性肝癌 血管造影 DSA 术后 肝动脉-门静脉瘘 造影分析 肝动脉化疗栓塞术 

分 类 号：R735.7[医药卫生—肿瘤] R816.2[医药卫生—临床医学]