网膜动脉参与原发性肝癌血供之影像特征及栓塞治疗的临床价值

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1、DOI：10.16016/j.1000-5404.201410151网膜动脉参与原发性肝癌血供之影像特征及栓塞治疗的临床价值王宇西，罗小平，刘曦，何明菊，杨伟(400010重庆，重庆医科大学附属第二医院放射科)[摘要]目的探讨大网膜动脉参与原发性肝癌血供的影像特征及完全性栓塞治疗的临床价值。方法收集本院2010-2014年行经导管肝动脉化疗栓塞（transcatheterarterialchemoembolization，TACE）治疗发现大网膜动脉（omentalartery，OA）参与原发性肝癌供血患者的影像及临床资料，回顾性分析OA参与肿瘤供血时

2、的影像特征，评估OA完全性栓塞治疗的安全性及有效性。结果36名患者于41次TACE治疗发现OA参与肿瘤供血。病灶均突破肝包膜，病灶位于肝S4、5段且于大网膜方向突破者13例(31.7%)，位于肝S5、6段且向下方外生生长者18例(43.9%)。53支OA参与肿瘤供血，血管造影特征明显。49支OA(92.5%)成功超选择性插管并完全性栓塞，未发现严重并发症。mRECIST方法分析28例，CR9例，PR13例，SD2例，PD4例，OA供血病灶栓塞有效率(Responserate，RR)为78.6%，肿瘤生长控制率(Diseasecontrolrate，DC

3、R)为85.7%。再次行TACE治疗15例，仅2例（13.3%）可见新生OA参与肿瘤供血。结论OA多参与位于肝S4～6段，并突破肝包膜或侵犯大网膜的大肝癌供血，血管造影特征明显。完全性栓塞OA肿瘤供血支安全性高，疗效好。[关键词]原发性肝癌；经导管肝动脉化疗栓塞；大网膜动脉；完全性栓塞［中图法分类号］R730.53;R735.7;R814.43［文献标志码］AImagingFeaturesofHepatocellularCarcinomawithBloodSupplyfromOmentalArteryandClinicalValueofTranscat

4、heterArterialChemoembolizetionWangYuxi，LuoXiaoping，LiuXi，HeMingju，YangWei(DepartmentofRadiology，SecondAffiliatedHospital，ChongqingMedicalUniversity，Chongqing，400010，China)［Abstract］ObjectiveToexploretheimagingfeaturesofthehepatocellularcarcinoma(HCC)withbloodsupplyfromomentalart

5、ery(OA)andcompletetranscatheterarterialchemoembolization(TACE).MethodsTheimagedataandclinicaldataofHCCwithbloodsupplyfromomentalarteryundergoneTACEinourhospitalfrom2010to2014werecollected.TheimagingfeatureswereanalyzedandthesafetyandeffectivenessofcompleteTACEwereevaluatedretros

6、pectively.ResultsTheHCCwithbloodsupplyfromOAwerefoundin36patientsunderwent41casesofTACE.Inallcases,tumorsshowedexophyticgrowth.In13cases(31.7%),tumorsweremainlylocatedinliversegment4、5andshowedexophyticgrowthinepiploicdirection.In18cases(43.9%),tumorsweremainlylocatedinliversegm

7、ent5、6andbrokethroughthehepaticcapsulardownward.53OAswerefoundtosupplyHCCwithclearlyangiographicfeatures.49OAs(92.5%)werecompleteocclusive,noseriouscomplicationwasrecorded.28casesanalyzedbymRECISTmethod,CRin9cases，PRin13cases，SDin2cases，PDin4cases.Responserate(RR)was78.6%,anddis

8、easecontrolrate(DCR)was85.7%.Angiographyweresho