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目的 评价小肠平滑肌类肉瘤肝脏转移的影像学表现和介入治疗的短期疗效。方法 回顾性分析７例小肠平滑肌类肉瘤肝脏转移病例，共计４６个病灶。病灶直径２～１８ｃｍ不等。所有患者均行肝脏ＣＴ三期扫描和肝动脉造影。介入治疗７例均采用肝动脉化疗栓塞术（ＴＡＣＥ），ｌ例行左锁骨下动脉植入化疗药盒导管系统术（肝动脉ＰＣＳ术）。３例肿瘤中心液化坏死明显的患者还行经皮坏死物引流和肿瘤内无水酒精注射。结果４６个肝脏转移病灶均表现为实质性或囊实性占位，肿瘤较大时囊变成份增加。ＣＴ动脉期增强扫描肿瘤明显强化，肝动脉造影肿瘤血管、染色丰富。随访３～１０月（平均６．７月），４例经肝ＴＡＣＥ术后肿瘤缩小，ｌ例行肝动脉ＰＣＳ术患者肿瘤大小无变化，２例肿瘤增大。３例经皮肿瘤坏死物引流者肿瘤缩小明显。结论 小肠平滑肌类肉瘤肝脏转移以肝动脉供血为主，为富血供肿瘤。肝ＴＡＣＥ术、肝动脉ＰＣＳ术和经皮坏死物引流术是其治疗的有效方法。
Objective To evaluate the imaging findings of liver metastasis of small intestinal smooth muscle sarcoma and the short-term efficacy of interventional therapy. Methods Retrospective analysis of seven cases of intestinal smooth muscle sarcoma cases of liver metastases, a total of 46 lesions. Lesions diameter ranging from 2 ~ 18cm. All patients underwent liver CT three-phase scan and hepatic arteriography. Interventional therapy in 7 cases were treated with transcatheter arterial chemoembolization (TACE), l routine left subclavian artery implantation chemotherapy kit catheter system (hepatic artery PCS). Three patients with obvious liquefaction and necrosis at the center of the tumor also underwent percutaneous debridement and intraperitoneal injection of anhydrous alcohol. Results All the 46 liver metastases showed substantial or cystic solid mass. When the tumors were large, the cystic components were increased. CT arterial phase enhanced scan significantly enhanced the tumor, hepatic artery angiography tumor blood vessels, rich in staining. All cases were followed up for 3 to 10 months (mean, 6.7 months). The tumor size was reduced in 4 cases after hepatic TACE. The tumor size was unchanged in 1 case of hepatic artery PCS, and the tumor size was increased in 2 cases. 3 cases of percutaneous tumor necrosis drainage tumor narrowed significantly. Conclusions The hepatic metastasis of small intestinal smooth muscle sarcoma is mainly hepatic artery, which is rich in blood for tumor. Hepatic TACE, hepatic artery PCS and percutaneous necrosis drainage is an effective method of treatment.