巨大肝血管瘤的双重介入治疗  

Treatment of huge hepatic cavernous hemangioma with double intervention

作　　者：丁汇清[1] 张海军[2] 杨立民[2] 张名忠[1] 朱云炜[1] 陈岩[1] 乔乃春[1] 

机构地区：[1]连云港市第一人民医院东方医院介入放射科,江苏连云港222042 [2]连云港市第二人民医院放射科,江苏连云港222023

出　　处：《中国介入影像与治疗学》2009年第2期127-130,共4页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的探讨巨大肝血管瘤(HCH)的双重介入治疗技术及疗效。方法103例经临床、影像学证实的HCH中,18例巨大HCH患者共27个瘤灶均接受肝动脉栓塞术(THAE)和瘤内注射术(PEI)双重介入治疗。根据术前与术后3～6个月螺旋CT表现,比较HCH缩小程度。HCH缩小程度分级:≤1/4原瘤体的为Ⅰ级,等于原瘤体1/4～1/2的为Ⅱ级,<原瘤体1/2～3/4的为Ⅲ级,<3/4瘤体的为Ⅳ级。强化程度分级:轻度强化:≤1/3瘤周、充填范围≤1/3瘤体,中度强化:≤1/2瘤周、充填范围≤1/2瘤体,明显强化:充填>1/2瘤周、充填范围>1/2瘤体三种类型。碘油沉积程度判断:HCH瘤内碘油沉积≤1/3瘤体的为一般,1/3～1/2瘤体的为较好,>1/2瘤体的为很好。结果18例27个瘤灶的缩小程度分别为:Ⅰ级2个,Ⅱ级3个,Ⅲ级8个,Ⅳ级14个。27个瘤灶中,3个轻度强化,其中1个碘油沉积情况一般;9个中度强化,其中7个油沉积情况较好;15个明显强化,其中13个碘油沉积很好。结论双重介入治疗巨大HCH是有效的。Objective To study the double interventional radiologic therapy on the huge hepatic cavernous hemangioma （HHCH）. Methods Twenty-seven lesions in 18 cases with HHCH were confirmed by clinical and imaging examinations. All HHCHs were treated with transcatheter hepatic arterial embolization （THAE） and CT or DSA guided percutaneous ethanol injection （PEI）. The shrink degrees of the HHCH were compared according to the helical CT findings 3 to 6 months before and after interventional treatment. The shrink degrees of HHCH were divided as follows： smaller than 1/4 volume of the primary lesion as degree I , 1/4 to 1/2 volume as degree]] , 1/2 to 3/4 volume as degree HI and larger than 3/4 volume as degree IV. Enhancement degree was divided into three types： smaller than 1/3 circumference and volume of the primary lesion as light, 1/3--1/2 as medium and larger than 1/2 as obvious. Lipiodol retention degree was divided as follows： smaller than 1/3 volume of the primary lesion as ordinary, 1/3--1/2 as fine and larger than 1/2 as good. Results Two lesions were degree I , 3 were degree Ⅱ , 8 were degree Ⅲ and 14 were degree IV. Among 27 lesions, 3 lightly en- hanced, 9 mediumly enhanced and 15 obviously enhanced. Lipiodol retention in three enhancement types was 1, 7 and 13, respectively. Conclusion It is effective to treat HHCH with THAE and PEI.

关 键 词：肝脏 血管瘤 海绵状 超声检查 介入性 

分 类 号：R735.7[医药卫生—肿瘤]