肝癌介入治疗对靶血管损害的影像学评价及预防

本文回顾分析具有完整血管造影记录的263例肝癌介入治疗病例,采用介入治疗前后自身比较的方法评价靶血管近段的形态变化,观察其受损情况。结果发现:受损血管共85支,总受损率为32.2％,明显高于文献报道的单次血管造影和介入治疗所致的靶血管受损率。其中17.0％的损害导致选择性插管发生困难或失败,引起肿瘤侧枝循环形成而影响了介入疗效.受损血管的形态学改变可分为五类:1.毛糙或小波浪状(7.2％);2.局限性环形狭窄(14.8％);3.细线样狭窄(3.0％);4.串珠样狭窄(4.6％);5.完全闭塞(2.6％)。本文讨论了引起血管损伤的原因以及与受损后的血管外形改变的关系,并提出了预防和减少血管损伤的方法和意见。

Imeging evaluation and prevention of arterial damage during interventional treatment of liver cancer

Retrospective study and self-comparison of angiographing after and before interventional management in 263 patients with advanced liver cancer were reviewed to evaluate the arterial damage.The results showed that 85 arterial branches were injured and the total rate of damage reached 32.3%, which was obviously higher than the previous reports.Of which, 17.0% arterial damage led to difficulty or failure for further superselective catheterization, and caused formation collateral of circulation reducing the effectiveness of the treatment.5 types of arterial damage were discussed together with the correlation betreen causes and angiographic appearances.Methods of prevention and reduction for the incidence were emphysized.