肝癌的规则性、变异性、寄生性供血及对TACE治疗的影响

目的探讨肝癌的规则性、变异性、寄生性供血情况,以提高TACE治疗肝癌的疗效。方法回顾分析经病理及影像资料证实的肝癌病灶52枚。行常规DSA造影,当发现肿瘤无染色或动脉期存在部分无血管区及实质期充盈缺损时,再分别行肠系膜上动脉、胃左动脉、膈下动脉、右肾上腺动脉、胸廓内动脉、肋间动脉DSA造影。结果肝癌的规则性供血病灶39枚,占75%;肝癌的变异性供血病灶13枚,占25%;肝癌的寄生性供血病灶11枚,占21%。结论肝癌病灶主要供养动脉来自肝动脉的规则性供血,但尚有25%的肝癌病灶存在变异性供血。积极地通过肝癌的规则性、变异性、寄生性供血动脉进行肝癌的化疗栓塞,能进一步提高疗效。

The Regular , Variant and Parasitic Arterial Blood Supply in Liver Cancer and its Effect on Transhepatic Artery Chemoembolization (TACE) Treatment

Objective To investigate the regular,variant and parasitic arterial blood supply in liver cancer,so as to improve the effects of treatment on liver cancer by TACE.Methods 52 liver cancer focus confirmed by pathology and imaging were retrospectively analysed First,the routine DSA was performed,if following conditions including no tumor staining or no vessel area within tumor on arterial phase and filling defect within tumor on parenchyma phase were presented,then DSA via superior mesenteric artery,left gastric artery,inferior phrenic artery,right adrenal artery,internal thoracic artery and intercostal artery were perfomed again.Results 39 focus with regular arterial blood supply(75%),13 focus with variant (25%) and 11 focus with parasitic arterial blood supply (21%) are observed .Conclusion The liver cancer focuses are mainly fed by the regular arterial blood supply of liver artery ,but still 25% are by variant arterial blood supply.The chemoembolization for liver cancer through regular ,variant and parasitic arterial blood supply can improve the therapeutic effect.