肝动脉化疗栓塞后并发局限性脂肪肝原因探讨及影像学表现  

The Study on the Etiology and Imaging Feature of Focal Fatty Liver after Transcatheter Hepatic Artery Chemotherapeutic Embolization

作　　者：张战利[1] 肖刚 申晋昌 王建利[1] 薛南[1] 郭秋霞[1] 荆利民[2] 王存强[2] 

机构地区：[1]河南省新乡市第一人民医院介入中心,河南新乡453000 [2]河南省新乡市第一人民医院CT室,河南新乡453000 [3]新乡市妇幼保健院放射科 [4]解放军第371医院介入科

出　　处：《实用放射学杂志》2009年第9期1340-1343,共4页Journal of Practical Radiology

摘　　要：目的分析肝动脉介入化疗栓塞后局限性脂肪肝影像学特征。方法4例肝癌患者术前均经超声、CT检查确定无脂肪肝行肝动脉化疗栓塞（TACE），后进行超声、CT检查并行经皮肝穿刺活检检测脂肪肝情况。结果经肝动脉化疗栓塞术（TACE）后，CT、B超显示肝右下叶局限性低密度区其内可见密度较高肝静脉影像，增强后病变区强化不明显，动脉走行自然。腹部超声显示呈细腻回声增强兼后部回声衰减；血管造影显示右下叶肝动脉走行自然，动脉期未见血管增粗、迂曲或抱球征象，实质期也末见肿瘤染色现象。病理证实为肝脂肪变性。结论了解经肝动脉化疗栓塞术（TACE）并发局限性脂肪肝原因及影像学表现有助于更好地开展肝癌的介入治疗。Objective To analyse the imaging findings of focal fatty liver after transcatheter hepatic artery chemotherapeutic embolization（ACE） Methods Four cases with hepatocellular carcinomas underwent TACE,no fatty liver before low density in the posterior segment of right lobe confirmed by sonography and CT. All cases were examined with sonography, CT and percutaneous hepatic biopsy after TACE to detect whether or not having fatty liver. Results Sonography and CT showed local low density in all cases in the posterior segment of right lobe of the liver, and the vessels were seen as relatively high attenuation structures against a background of low density parenchyma on CT. Post-contrast CT revealed no enhancement of the affected parenchyma, while the hepatic arteries were enhanced obviously with no evidence of enlargement and tortuousity. The abdominal sonography showed an increased echo in the affected parenchyma, in which the echo of the liver was similar to that of the central echo of the kidney. Biopsy specimens of the affected parenchyma from one patient under sonographic guidance revealed fatty degeneration of the liver. Conclusion Recognition of the reason and the imaging features of local fatty liver following TACE can help us carry on the interventional treatment of hepatic tumors more efficiently.

关 键 词：肝脏 化疗栓塞 肝脂肪变 并发症 

分 类 号：R575[医药卫生—消化系统] R815[医药卫生—内科学]