原发性肝癌术后早期DSA影像表现  

DSA Manifestations of Primary Liver Carcinoma Early After Resection

作　　者：徐国斌[1] 易广新 鲁植艳[1] 丁勋[1] 周军[1] 龙清云[1] 吴光耀[1] 

机构地区：[1]武汉大学中南医院放射科,430071 [2]新疆博州人民医院介入室,833400

出　　处：《临床放射学杂志》2013年第8期1155-1158,共4页Journal of Clinical Radiology

摘　　要：目的探讨原发性肝癌切除术后早期DSA介入诊疗的影像表现特点。方法 45例原发性肝癌患者手术切除后行辅助性肝动脉化疗灌注或栓塞治疗,结合6个月随访期内CT及甲胎蛋白等资料,分析肝癌术后早期各种DSA影像表现及其诊断价值。结果早期DSA表现分为4类:(1)术后正常改变:27例。肝动脉及门静脉呈部分切除后改变,残肝动脉形态分布较规则,末梢血管增多并于切缘形成条片状或环形染色。(2)血管合并症:5例。并发肝动脉-门静脉瘘,见门静脉分支或主干提前显影。(3)肝内肿瘤复发/转移:10例。切缘复发肝动脉末梢增多杂乱,呈团块状或串珠状肿瘤染色;肝内复发/转移表现为单个或多发结节或团块影。碘油乳剂栓塞后杂乱血管消失,碘油明显沉积。(4)可疑肝内复发/转移:3例。肝动脉末梢增多较杂乱,碘油无明显沉积。DSA诊断术后复发/转移正确率为92.8%。结论原发性肝癌切除术后早期具有多种DSA表现,可以较准确地区分术后正常改变、血管合并症及肿瘤复发转移并指导介入治疗。Objective To study DSA manifestations of primary liver carcinoma（PLC） early after resection. Methods Forty five patients with PLC performed operation and adjuvant transcatheter arterial chemo-infusion or chemoemboliza- tion. DSA image findings and CT or AFP datum were analyzed at 2- 8 weeks after operation. Results Early DSA image manifestations were classified into four types inDSA image manifestations included four types ： （ 1 ） normal changes （ n = 27 ）. Hepatic vessels were absent partly and residual hepatic artery distributed regularly. Distal hepatic vessels closed to in- cisal edge were increased and cambered stained. （2）Vessel complications （n = 5 ）. Included hepatic arterioportal shunt （APS）. （3） Tumor recurrence or metastasis （n = 10）. Tumors recurred near incisal region and disseminated into other ar- ea. Distal clutter tumor vessels and anomalous bead like tumor stained could be found near incisal recurrence. Single or multiple nodules or masses as well as iodized oil retention were also showed. （4） Suspicious intrahepatic tumor recurrence or metastasis （ n = 3 ）. Dubious tumor vessels and stained without iodized oil deposition. Diagnostic accuracy rate of intra- hepatic recurrence or metastasis after resection on DSA was 92.8%. Conclusion DSA image manifestations are helpful for early evaluating PLC recurrence or metastasis and guiding interventional treatment.

关 键 词：原发性肝癌 数字减影 血管造影 影像 肝切除术 

分 类 号：R735.7[医药卫生—肿瘤]