迷走肝动脉的DSA研究及临床意义

目的 研究迷走肝动脉的解剖特征，探讨其临床意义。资料与方法 回顾分析1000例肝动脉DSA资料，将直接起自腹腔干及胃肠道供血动脉的变异肝动脉称之为迷走肝动脉（aberrant hepatic artery,AbHA)，并根据其在肝内的走行方向和分布范围不同，进一步将其分为迷走肝右动脉（aberrant right hepatic artery,AbRHA），迷走肝左动脉（aberrant left hepatic artery,AbLHA)，迷走肝中动脉（aberrant middle hepatic artery,AbMHA)，迷走肝固有动脉（aberrant proper hepatic artery,AbPHA)及迷走肝总动脉（aberrant common hepatic artery,AbCHA）等，分别统计其发生率，描述其起源、走行、分支、分布等解剖学特征。结果 1000例中，共发现210例存在AbHA，占21％，其中12例分别显示2支AbHA，共发现222支AbHA，其构成如下：AbRHA 102支（45.95%,102/222)，AbLHA88支（39.64%,88/222)，AbMHA 4支（1.80%,4/222),AbPHA 3支（1.35%,3/222)，AbCHA 25支（11.26%,25/222)。222支AbHA中，起于肠系膜上动脉114支（51.35%,114/222)，起于胃左动脉83支（37.39%，83／222），起于胃十二指肠动脉13支（5.86%,13/222)，起于腹腔干10支（4.50%,10/222)，起于胃右动脉2支（0.90%,2/222)。结论 AbHA是一种比较常见的肝动脉变异，熟悉这种血管变异对肝癌的动脉内化疗栓塞具有极其重要的临床意义。

Aberrant Hepatic Artery: A Study with DSA and Its Clinical Significance

Objective To investigate anatomic characteristics and clinical significance of aberrant hepatic artery (AbHA). Materials and Methods DSA manifestations in 1000 hepatic arteriography were retrospectively reviewed. The AbHA was defined as these liver feeding arteries which directly originated from the celiac axis or from the gastrointestinal arteries. According to their course and distribution within the liver, AbHAs were further subdivided into aberrant right (AbRHA), left (AbLHA), middle (AbMHA), proper (AbPHA) and common (AbCHA) hepatic artery. The frequency of each of them was summed up and their anatomic characteristics, such as origin, course, branches and distribution, were described. Results Of 1000 cases, AbHA was found in 210 cases (21%) with 12 cases having two AbHAs. The total 222 AbHAs included AbRHA (n=102, 45.95%), AbLHA (n=88, 39.64%), AbMHA (n=4, 1.80%), AbPHA (n=3, 1.35%) and AbCHA (n=25, 11.26%). The AbHAs was originated from superior mesenteric artery (n=114, 51.35%), left gastric artery (n=83, 37.39%), gastroduodenal artery (n=13, 5.86%), celiac axis (n=10, 4.05%) and right gastric artery (n=2, 0.90%).Conclusion AbHA is a common variation, A knowledge of this variation is very important in doing transcatheter arterial chemoembolization for the treatment of liver cancer.