中晚期原发性肝癌血供的影像学分析

目的　观察中晚期原发性肝癌血供。方法　中晚期原发性肝癌 3 1例 ,通过数字减影血管造影和CT血管造影观察其血供 ,化疗检塞术后 4周行碘油CT复查。结果　本组 3 1例中 2 8例为单纯肝动脉供血 ,3例为肝动脉和侧支动脉供血 ,未见门脉供血。单层动态扫描时间 密度曲线显示 :癌组织在CTHA显著强化 (P <0 .0 5 ) ,在CTAP无显著强化 (P >0 .0 5 ) ;单层动态扫描与术后碘油CT的肿瘤最大截面积无显著差异 (P >0 .0 5 )。结论　中晚期肝癌以肝动脉供血占绝对优势 ,部分可见侧支动脉供血 ,未见门脉血供。

Imageologic Analysis of Blood Supply in Advanced Primary Hepatic Carcinoma

Objective To evaluate the blood supply in advanced primary hepatic carcinoma. Methods Thirty one cases with advanced primary hepatic carcinoma, before their first TACE, all underwent digital subtraction angiography (DSA) and computed tomographic angiography (CTAP and CTHA) of the liver. Lipiodol CT (Lp CT) were performed 4 weeks later after TACE. Results All of 31 cases showed the evidence of blood supply from hepatic artery, 28 cases(90.3%) simply from hepatic artery, 3 cases (9.3%) from both hepatic artery and collateral artery, no case showed the sign of the portal vein supply. In single level dynamic scanning of CTHA and CTAP, the time attenuation curves showed that the degree of enhancement between the tumor and the parenchyma had significant deference in CTHA ( P <0.05), but had no significant deference in CTAP ( P >0.05) . The areas of the tumors which showed in CTHA and CTAP at the same level had no significant deference ( P >0.05). Conclusion All the tumors in 31 cases with advanced primary hepatic carcinoma showed that blood supply was mostly from hepatic artery or hepatic artery and collateral arteries, and none from the portal vein.