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目的：观察胸廓内动脉（ＩＴＡ）参与肝脏肿瘤供血的影像表现和介入治疗效果。材料与方法：４年间发现ＩＴＡ参与肝癌供血６例，经血管造影证实，男性５例，女１例，年龄３６～５２岁，均有超声波及ＣＴ检查资料，３例曾做ＭＲＩ检查。既往均曾行肝动脉化疗栓塞（２～８次）。ＩＴＡ造影用５Ｆ眼镜蛇形导管，对向肿瘤供血的ＩＴＡ分支行栓塞治疗，２例用同轴微导管。结果：肝癌均为巨块型，位于肝脏前部、包膜下，伴有局部肝包膜侵犯３例，６例ＣＴ片均显示右侧胸廓内血管影增粗。ＩＴＡ造影显示均为右侧ＩＴＡ分支参与肿瘤供血，栓塞治疗均成功。术后ＣＴ复查显示肿瘤缩小或／和瘤区碘油积聚增多，末次治疗前αＦＰ＞２００μｇ／Ｌ３例，术后逐渐降至正常。ＩＴＡ栓塞后并发胸／腹壁皮肤损伤３例。结论：位于肝脏前部、包膜下的肿瘤可接受ＩＴＡ供血；在经ＩＴＡ途径行栓塞治疗时应警惕皮肤损伤并发症。
Objective: To observe the imaging performance and interventional effect of intrathoracic internal arteries (ITA) involved in liver tumors. Materials and Methods: In 4 years, ITA was found to participate in 6 cases of liver cancer. It was confirmed by angiography that there were 5 males and 1 female, aged 36-52 years old. All had ultrasound and CT examination data, and 3 cases had MRI examination. All previous hepatic arterial chemoembolization (2-8 times). The ITA was performed with a 5F Cobra-shaped catheter and embolized on the ITA branch feeding blood to the tumor. In 2 cases, the coaxial microcatheter was used. RESULTS: All the liver cancers were massive, located in the anterior part of the liver and subcapsular with 3 cases of partial liver capsule invasion. All the 6 CT films showed thickening of blood vessels in the right thorax. ITA imaging showed that the right ITA was involved in tumor blood supply and embolization was successful. Postoperative CT examination showed tumor shrinkage and/or accumulation of iodized oil in the tumor area. Before the final treatment, α-FP was more than 200 μg/L in 3 cases and gradually decreased to normal after surgery. After ITA embolization, chest/abdominal skin lesions occurred in 3 patients. Conclusions: Tumors located in the anterior part of the liver and subcapsular can receive ITA blood supply; they should be aware of the complications of skin injury when embolized by the ITA route.