【摘要】 目的　研究大肝癌右膈动脉开放的DSA表现特点及临床价值 ,以提高介入治疗的临床疗效。资料与方法　高度选择性插管至供应癌肿的右膈动脉进行DSA检查并分析其影像特点 ,同时进行栓塞治疗 ,观察治疗效果。结果　本组 4 5 8例直径 5～ 15cm大肝癌在介入治疗术中发现右膈动脉供应癌肿血液者 96例 (2 0 .9% ) ,其中首次介入治疗时发现 4 2例 (9.2 % ) ,第 2～ 3次介入治疗时发现 5 4例 (11.8% ) ;经高度选择性栓塞治疗后 ,所有病例的供血微血管均显著减少或消失 ,病灶均明显缩小 ;6个月生存率 10 0 % (96例 ) ,1年生存率 80 .2 % (77例 ) ,2年生存率35 .4 % (34例 )。结论　右膈动脉是中晚期肝癌的重要供血侧支动脉 ,认识其供血特点并正确处理是中晚期肝癌介入治疗成功的关键之一。更多还原

【Abstract】 Objective To study DSA features of the right inferior phrenic artery which provides blood supply to the tumor in the patients with advanced hepatic cancer, to improve the clinical results of interventional therapy.Materials and Methods Super-selective right inferior phrenic artery, which acted as one of the tumor-feeding arteries, DSA was performed in 96 patients with advanced hepatic cancer. Interventional embolization was carried out at the same time. The therapeutic effectiveness was observed.Results Of 458 cases with huge hepatic cancer (tumor’s diameter 5～15cm), the right inferior phrenic artery which acted as the tumor-feeding artery was found in 96 (20.9%), of which 42 (9.2%) were discovered during the first interventional procedure and 54 (11.8%) during the second or the third interventional procedure. After super-selective embolization of the right inferior phrenic artery, obvious reduction, or even disappearing, of the tumor-feeding microvessels and marked shrinking of the lesion were observed in all cases. The survival rate for 6, 12 and 24 months was 100%, 80.2% and 35.4%, respectively. Conclusion The right inferior phrenic artery is usually one of the main collaterals in advanced hepatic cancer. Knowledge of this artery and proper treatment of tumor-feeding arteries are very important for a successful therapy of advanced hepatic cancer.更多还原