经肝动脉、门静脉肝转移瘤分布及血供特点的比较研究  

Distribution and Blood Supply Chatacteristics of Hepatic Metastases Via Hepatic Artery and Portal Venous

作　　者：王静 陈波[2] 郑建军[2] 金中高[2] 

机构地区：[1]南方医科大学深圳医院影像中心,518100 [2]浙江省宁波市第二医院放射科,315010

出　　处：《临床放射学杂志》2017年第12期1816-1820,共5页Journal of Clinical Radiology

基　　金：浙江省2017年医药卫生科技计划资助项目(编号:2017KY138)

摘　　要：目的对肝动脉及门静脉肝转移瘤的分布及血供特点进行比较。方法按既定标准对转移瘤患者60例的CT平扫及标准双期增强扫描进行回顾性分析,包括结肠癌及肺癌肝转移患者各30例。根据Couinaud肝段划分法和对肝脏最大瘤灶定位,采用肝动脉增强分数(AEF)评价肿瘤血供,对两组间瘤灶分布、正常肝组织及瘤灶AEF进行比较,对瘤灶直径与AEF进行相关性分析。结果经门静脉肝转移瘤主要分布在肝右叶,占70.0%(21/30);经肝动脉转移瘤73.3%分布在肝左叶(22/30),两组间瘤灶分布具有统计学差异(P=0.00)。肝动脉途径转移瘤AEF(0.68)高于门静脉途径转移瘤(0.52),差异有统计学意义(P=0.01)。两组转移瘤病灶直径变化与AEF变化之间无相关性(r=0.10、0.21)。结论不同路径肝转移瘤的分布和血供均存在一定差异,有助于为肝转移瘤寻找原发肿瘤抑或是原发肿瘤查找肝转移瘤提供一定的指向性。Objective To compare the distribution and blood supply of liver metastases via hepatic artery and portal vein. Methods 60 cases confirmed of metastates underwent CT pre-and post-contrast enhanced scan were retrospectively analyzed,including primary colon and lung cancer 30 cases,respectively. The maximum liver metastases were localized according to Couinaud nomenclature,and hepatic arterial enhancement fraction（ AEF） was used to assess blood supply of liver metastases. The distribution and AEF of liver tumors between two groups were compared and the diameter with AEF of liver tumor was correlated. Results The liver metastases via portal vein were mainly distributed in the right hepatic lobe,accounted for 70. 0%（ 21/30）; while 73. 3%（ 22/30） of liver metastases Via hepatic artery located in the left lobe,the distribution between the two groups has statistical difference（ P = 0. 00）. The AEF of metastases via hepatic artery way（ 0. 68） was higher than that via portal vein（ 0. 52）,the difference was statistically significant（ P = 0. 02）. There was no correlation between lesions＇ diameter and AEF in two groups of metastatic tumors（ r = 0. 10,0. 21）. Conclusion Variable paths of liver metastases showed some differences both in distribution and blood supply,which is helpful to distinguish hepatic metastases from different primary.

关 键 词：肝 转移瘤 分布 血液供应 

分 类 号：R730.44[医药卫生—肿瘤] R735.7[医药卫生—临床医学]