钇-90微球治疗肝脏恶性肿瘤的术前肝血管评估——钇-90微球放射栓塞系列回顾(三)  

Pretherapeutic aassessment of the hepatic arterial vasculature for hepatic malignancy with yttrium-90 radioembolization.A series review of radioembolization with ^(90)Y microspheres(part Ⅲ)

作　　者：贾中芝[1] 赵添[2] 王斯妮[2] 郑丽丽[2] 谢双双[3] 王维平 JIA Zhongzhi;ZHAO Tian;WANG Sini;ZHENG Lili;XIE Shuangshuang;WANG Weiping(Department of Interventional Radiology, No.2 People＇s Hospital of Changzhou, Nanjing Medical University, Changzhou, Jiangsu Province 213003, China)

机构地区：[1]南京医科大学附属常州市第二人民医院介入血管科,江苏常州213003 [2]温州医科大学附属第一医院介入科 [3]天津市第一中心医院放射科 [4]美国梅奥诊所放射科

出　　处：《介入放射学杂志》2017年第12期1151-1159,共9页Journal of Interventional Radiology

基　　金：江苏省常州市高层次卫生人材培养工程项目(2016CZBJ009)

摘　　要：钇-90(^(90)Y)放射栓塞的潜在风险是在灌注微球过程中意外发生非靶血管栓塞。因此,术前采用肝动脉造影的方法来仔细确认有无潜在风险的动脉和血管交通尤其重要。完整的术前肝血管评估包括选择性肝动脉造影、预防性栓塞有导致^(90)Y微球异位栓塞风险的动脉和确定继发于肿瘤病理性动静脉瘘产生的肝肺分流。本文将讨论^(90)Y栓塞治疗过程中有可能引起非靶血管栓塞的相关动脉解剖以及如何评估这些血管的风险,预防非靶血管栓塞发生的方法 。Potential complications arising from yttrium-90 （9oy） radioembolization are often related to inadvertent embolization of non- target vasculature during particle administration. Therefore, careful pre-therapeutic planning with arterial mapping is especially important to help identify potential high-risk arteries and vascular communications. A complete pre-therapeutie evaluation of hepatic arterial vasculature includes selective arteriography, precautionary embolization of potential risk arteries and identification of occurrences of hepatopulmonary shunting secondary to tumor-related pathologic arteriovenous channels. The aim of this review is to discuss the pertinent arterial anatomy during 90y radioembolization therapy and strategies on how to evaluate the risk and prevent the occurrence of non-target embolization through those vascular structures.

关 键 词：钇-90 放射栓塞 动脉造影 栓塞 

分 类 号：R730.55[医药卫生—肿瘤] R735.7[医药卫生—临床医学]