肝癌合并腹腔动脉与肠系膜上动脉侧支循环通路假性闭塞(附12例报告)  

False occlusion of the collateral circulation between the celiac artery and superior mesenteric artery of hepatocellular carcinoma

作　　者：戚跃勇[1] 邹利光[1] 戴书华[1] 陈卫军[2] 熊坤林[3] 朱结辉[4] 陈晓良[5] 

机构地区：[1]第三军医大学新桥医院放射科,重庆400037 [2]第三军医大学解剖学教研室,重庆400038 [3]第三军医大学大坪医院放射科,重庆400042 [4]第三军医大学西南医院放射科,重庆400038 [5]重庆市肿瘤医院放射科,重庆400040

出　　处：《医学影像学杂志》2003年第5期321-323,共3页Journal of Medical Imaging

摘　　要：目的 :探讨肝癌合并腹腔动脉与肠系膜上动脉侧支循环通路假性闭塞的血管造影表现及其在介入治疗中的价值。方法 :回顾性分析 12例该类患者的肠系膜上动脉造影 ,腹腔动脉造影及介入治疗资料。结果 :12例假性闭塞中 ,位于肝总动脉与腹腔动脉分叉处 6例 ,肝总动脉分出胃十二指肠动脉支处 5例 ,1例右肝动脉直接起源于腹腔动脉 ,并在其分叉处发生假性闭塞。在这 12处假性闭塞中 ,于腹腔动脉造影时呈闭塞状态 ,而肠系膜上动脉造影却完全通畅 ,似静脉瓣样 ,并且导丝、导管能顺利通过该闭塞处。 10例患者完成了肝动脉化疗栓塞术。结论 :这一少见现象可能与其血液动力学改变和解剖学变异有关 ,了解此征象对于指导介入治疗有一定价值。Objective:To explore the angiographic appearances and interventional therapy of the false occlusion of the collateral circulation between the celiac artery and superior mesenteric artery of primary hepatocellular carcinoma.Methods:Twelve patients with the false occlusion who underwent superior mesenteric arteriography(SMA),celiac arteriography(CA) and interventional therapy were reviewed.The DSA appearances in all of the patients were observed dynamically.The presence of the false occlusion of the hepatic artery was determined by two experienced radiologists who read the angiograms together and formed a consensus interpretation.Results:Among the 12 patients with the false occlusion,6 cases were found at the crotch of common hepatic artery and celiac artery,5 cases at the crotch of common hepatic artery and gastroduodenal artery,and 1 case at the crotch of right hepatic artery and celiac artery.The artery with the false occlusion seemed to be occlueded completely through CA,but it was well patent through SMA,and the angiography wire and catheter can pass it through easily,so it seemed to be vein valve.Transarterial chemoembolization (TACE) have been done in the 10 patients.Conclusion:The hepatic artery with the false occlusion is a rare phenomenon.Although the causes of it in those cases were not identified completely,it may be related to the hemodynamic change and the hepatic arterial abnormality.It is very important to understand the false occlusion in order to guide the selective catheterization and TACE.

关 键 词：肝癌 血管造影术 栓塞治疗 

分 类 号：R735.7[医药卫生—肿瘤] R814.43[医药卫生—临床医学]