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目的 研究肠细膜上动脉供血型(即变异肝动脉起源于肠细膜上动脉)肝癌的血管造影表现及插管技术。 方法 回顾分析41例肠细膜上动脉供血型肝癌的DSA及介入治疗资料,统计血管解剖变异的发生率,对其起源、走行、分支、分布等解剖学特征及其与血管插管的关系进行描述和分析。 结果 350例肝癌中,肠细膜上动脉供血型41例(11.9％),其中副肝右动脉15例(36.5％),替代肝右动脉16例(39.0％),肝总动脉8例(19.5％),腹腔动脉干起源于肠细膜上动脉2例(5％)。31例肠细膜上动脉发出替代或副肝右动脉者,29例(94.0％)腹腔动脉造影表现为肝右动脉细小或缺如,肝右叶出现无血管区。RH导管超选择性插管成功25例(61％),未成功者改用Cobra、Simmon导管以及结合微导管技术后获得成功。 结论 肠系膜上动脉供血型肝癌是一种比较常见的肝动脉变异性供血,熟悉其血管变异的特点对肝动脉化疗栓塞术具有重要的意义。
Objective To study the angiographic manifestations and intubation techniques of hepatic carcinoma of the superior mesenteric artery (ie, the origin of the variant hepatic artery originated from the superior mesenteric artery). Methods Retrospective analysis of 41 cases of intestinal mesenteric artery donor liver cancer DSA and interventional treatment data, statistical analysis of the incidence of vascular anatomy, its origin, walking, branching, distribution and other anatomical features and its relationship with vascular intubation Description and analysis. Results Among the 350 cases of hepatocellular carcinoma, 41 cases (11.9%) had supratentorial superior arteries, of which 15 cases (36.5%) had right accessory hepatic artery, 16 cases (39.0%) replaced right hepatic artery, 8 cases %), Celiac artery originated in the superior mesenteric artery in 2 cases (5%). Among the 31 cases, the superior mesenteric artery gave rise to surrogate or accessory right hepatic artery. In 29 cases (94.0%), the celiac artery angiography showed the small or absent hepatic artery, and the absence of vascular area in the right lobe of the liver. RH catheter selective catheterization success in 25 cases (61%), unsuccessful use of Cobra, Simmon catheter combined with microcatheter technology was successful. Conclusion The superior mesenteric artery donor liver cancer is a kind of common hepatic arterial variability blood supply, familiar with the characteristics of its vascular variation of hepatic artery chemoembolization is of great significance.