原发性肝癌自发破裂出血的数字减影血管造影特征及急诊动脉栓塞治疗效果  

Digital subtraction angiography features of spontaneous rupture and hemorrhage of primary liver cancer and the clinical effect of emergency selective arterial embolization

作　　者：顾国清 胡波 张川 

机构地区：[1]上海市闵行区中心医院放射科,上海201199

出　　处：《肿瘤影像学》2013年第2期189-191,共3页Oncoradiology

摘　　要：目的探讨原发性肝癌(简称肝癌)自发破裂出血的数字减影血管造影(DSA)表现特征及急诊动脉栓塞的治疗方法和临床疗效。方法收集我院13例经CT检查、B超检查及腹腔穿刺等方法证实为肝癌自发破裂并行急诊肝动脉造影栓塞的病例,分析肝癌破裂出血的DSA造影表现特征,根据DSA显示情况,经肝外寄生动脉或肝动脉急诊介入栓塞治疗,观察临床疗效。结果 13例肝癌破裂出血患者中,10例为真性出血、3例为隐性出血。隐性出血DSA表现为肿瘤周边血管缺损,没有明显造影剂外渗现象。所有患者均成功止血,短期临床效果满意。结论肝癌自发破裂出血有特殊的DSA特征,同时也存在假阴性病例,在临床上应重视。急诊动脉栓塞是治疗肝癌自发破裂出血的有效方法。Objective To investigate the digital subtraction angiography （DSA） features of spontaneous rupture and hemorrhage of primary liver cancer, and to explore the clinical effect of emergency arterial embolization. Methods A total of 13 cases with spontaneous rupture and hemorrhage of primary liver cancer, which were confirmed by CT, ultrasound examination or peritonrocentesis, were chosen in our hospital. All cases received emergency hepatic artery or parasitic artery embolization. The clinical efficacy was evaluated. Results There were 10 cases with true bleeding, and 3 cases with recessive bleeding, which DSA showed the defect of peripheral vascular around the tumor and no obvious contrast agent extravasation. All patients successfully achieved hemostasis. The short-term clinical results were satisfactory. Conclusion Spontaneous rupture and hemorrhage is a serious complication of liver cancer, resulting in high mortality. With special DSA features, there still exist some false negative cases. Emergency selective arterial embolization is effective in its treatment.

关 键 词：原发性肝癌 动脉栓塞 数字减影血管造影 自发破裂 

分 类 号：R735.7[医药卫生—肿瘤]