【摘要】 目的 探讨外生型肝癌(P-HCC)经导管动脉化疗栓塞(TACE)治疗前后血供特点。方法 回顾性分析39例P-HCC患者TACE治疗前后血管造影表现,总结其血供特点。结果 39例TACE术前血管造影发现有70支动脉参与供血,以39支(56.0%)肿瘤所在肝叶动脉供血为主,23例(59.0%)伴有31支(44.0%)肝外寄生性血管。TACE治疗前有无寄生性血管和肿瘤直径有相关性(χ~2=164.00,P<0.001),与部位无相关性(χ~2=7.358,P=0.061)。TACE治疗后所有血管造影发现有131支动脉参与供血,31例(79.5%)伴有肝外寄生性血管;其中肝内动脉53支(40.5%),肝外寄生性血管78支(59.5%),新增寄生性血管47支,呈逐渐增多(χ~2=4.278,P=0.039)。TACE术后肿瘤易由近邻血管获得寄生性供血。结论 P-HCC肿瘤TACE治疗前后血供以肝动脉为主,肝外寄生性血管为辅。寄生性血管与肿瘤大小密切相关,其血供丰富,来源以就近为原则。TACE治疗后易形成新的寄生性血管。更多还原

【Abstract】 Objective To investigate characteristics of blood supply in pedunculated hepatocellular carcinoma(P-HCC) before and after transcatheter arterial chemoembolization(TACE).Methods Angiographic findings before and after TACE treatment in thirtynine patients with P-HCC were analyzed retrospectively.Results Angiographies before TACE treatment showed 70 tumor feeding arteries in all patients,including 31(44.0%) extrahepatic parasitic arteries in 23 cases(59.0%).The relatively intrahepatic arteries participated and performed as the main blood supply for P-HCC in all patients.Extrahepatic parasitic blood supply for P-HCC correlated closely with the diameter of tumor lesion(χ~2=164.00,P<0.001),in contrary to their location(χ~2=7.358,P=0.061).After repeated TACE,angiographies showed a total of 131 tumor feeding arteries in all patients,including intrahepatic arteries(54/131) and extrahepatic parasitic arteries(78/131) being from 31 cases(79.5%).Compared to preoperative angiographies,it also showed an increasing trend in extrahepatic parasitic arteries which added 47 new blood vessels(χ~2=4.278,P=0.039).Tumor lesions of P-HCC were apt to get parasitic blood supply from adjacent vessels after repeated TACE.Conclusion The intrahepatic arteries perform as the main blood supply,whereas the extrahepatic parasitic arteries are complementary for P-HCC regardless of pre-or post-TACE.Extrahepatic parasitic blood supply is rich and closely associated with tumor size.Tumor lesions of P-HCC are apt to get and form new parasitic blood supply from adjacent vessels after repeated TACE.更多还原