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碘油门静脉造影以往多采用剖腹门脉置管来实现。笔者对18例肝内占位性病变患者采用经皮穿刺脾静脉灌注碘油的方法,完成门静脉造影,造影全部成功。术后没有发生脾破裂,脾出血及明显肝功能损害;18例肝肿瘤(直径1～18 cm)平片和 CT 扫描,瘤内及瘤周没有发现碘油沉积。笔者推测这是瘤内、瘤周的门脉分支高压或存在离肝血流的结果;本法有3例3 cm 以下的小结节灶检测数比常规 CT多,提示本法的敏感性可能与动门脉 CT 相似,从平片和 CT 观察瘤内及瘤周并没有象肝动脉灌注碘油那样有碘油充盈,而是呈充盈缺损,相反,正常肝组织分布碘油,这使得笔者对门脉置管化疗栓塞治疗肝癌的作用产生疑虑。
In the past, iodine oil portal vein angiography cesarean section catheter to achieve. The author of 18 cases of intrahepatic space-occupying lesions by percutaneous splenectomy lipiodol perfusion method to complete portal vein angiography, angiography all successful. No splenic rupture, splenic hemorrhage and obvious hepatic dysfunction occurred after operation. In 18 cases of liver tumor (1 ~ 18 cm in diameter) and CT scan, no lipiodol deposition was found in the tumor and peritumoral region. I presume that this is the tumor, peritubular portal vein pressure or the existence of the results from the liver blood flow; this method has 3 cases of 3 cm or less small nodules detection than regular CT, suggesting that the sensitivity of the law may Similar to arterial CT, plain and CT findings of tumor and peritumor did not result in filling with lipiodol as with hepatic arterial perfusion of lipiodol. Instead, lipiodol was distributed in normal liver tissue, allowing the author The role of portal vein chemotherapy chemoembolization in the treatment of liver cancer have doubts.