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目的 研究经皮肝动脉碘油化疗栓塞 (lipiodoltranscatheterarterialchemoembolization ,Lp -TACE)治疗肝癌后门静脉癌栓碘油沉积CT表现和意义。方法 42例肝癌患者行Lp -TACE ,灌注碘油 5～ 2 0ml不等 ,碘油用量以肿瘤内基本上被碘油完全充满为止。经螺旋CT 3期薄层扫描发现门静脉内碘油沉积。结果 在 42例患者中巨块型肝癌 3 4例、多结节性 8例 (包括术后复发 4例 ) ;3 6例为多血供 ,6例少血供 ;DSA时 3 1例有动静脉瘘 ,11例无明显动静脉瘘 ;碘油沉积于门静脉右支 18例、左支 9例和左右支及主干 15例 ,6例随着Lp -TACE的次数增加 ,门静脉癌栓内碘油量也增加 ;门静脉内碘油表现为条片状 16例 ,混合状 10例 ,团状和“双轨”状各 6例 ,点状 4例。结论 Lp -TACE可使碘油进入门静脉 ,碘油沉积于门静脉癌栓内呈现不同的表现 ,并可起到一定的治疗作用。
Objective To investigate the clinical significance of percutaneous transhepatic arterial lipiodol chemoembolization (Lp-TACE) in the treatment of posterior portal vein thrombosis induced by lipiodol. Methods Forty-two patients with liver cancer underwent Lp-TACE with perfusion of lipiodol ranging from 5 to 20 ml. The amount of lipiodol in the tumor was almost completely filled with lipiodol in the tumor. Three-phase spiral CT scan of portal vein lipiodol deposition was found. Results Of the 42 patients, 34 were massive bulky hepatocellular carcinoma (HCC), 8 were multi-nodular (including 4 recurrent cases), 36 were multiple blood donation and 6 were less blood supply. There were 31 cases with DSA Venous fistula, 11 cases without obvious arteriovenous fistula; lipiodol deposition in the right branch of the portal vein in 18 cases, left branch in 9 cases and left and right branches and trunk in 15 cases, 6 cases of Lp -TACE with the increase in the number of portal vein embolus lipiodol The amount of lipiodol in the portal vein showed 16 slices, 10 in mixed form, 6 in clumpy and “double track” shape and 4 in spots. Conclusion Lp-TACE can make lipiodol enter the portal vein, lipiodol deposition in the portal vein tumor emboli showed different performance, and can play a therapeutic role.