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目的:对肝动静脉分流影像诊断的效果进行分析和研究,探讨介入治疗效果。方法:对440例肝脏肿瘤患者的CT和DSA图像进行分析,其中70例患者为肝动脉-门静脉(APS)分流,肝动脉-肝静脉分流(AHVS)患者4例。同时对患者进行介入治疗。结果:在APS中,DSA的主要表现:门脉主干和相应大分支有36例显示清楚,门脉较小分支有18例显示,较细分支有16例显示。在AHVS中,DSA动脉期则主要表现为:肝昏迷有1条或者多条显示,主要表现为从细到粗,边缘比较清楚。然而APS采用CT动态增强扫描则为门静脉提前显示,但是脾静脉或者肠系膜上静脉则没有显示。当患者存在AHVS时,在动脉期间,其膈顶下层面能够看见肝静脉显示。介入治疗:采用TACE治疗有76例次、TAI有30例次。70例APS患者中,其中高流量22例、低流量48例。钢圈+明胶海绵+化疗为10例次、明胶海绵+化疗66例次、单纯化疗10例次。结论:在临床上,对患者采用DSA联合CT进行检查,能够对肝脏肿瘤患者是否存在动静脉分流情况进行准确诊断;此外,DSA还能够对分流的流量和性质以及部位进行确定,对后续的介入治疗提供一定的参考。
Objective: To analyze and study the effect of hepatic arteriovenous shunt imaging to explore the effect of interventional therapy. Methods: CT and DSA images of 440 patients with liver tumors were analyzed. Seventy patients were divided into hepatic artery - portal vein (APS) and hepatic artery - hepatic venous shunt (AHVS) in 4 patients. At the same time, the patient intervention. Results: In APS, the main manifestations of DSA were as follows: 36 cases of portal vein and its corresponding major branches were clearly shown, 18 cases of minor branches of portal vein and 16 cases of subtle branches. In AHVS, DSA arterial phase is mainly manifested as: hepatic coma with one or more shows, mainly from thin to thick, the edge more clearly. However, the APS showed anterior portal vein with CT dynamic contrast-enhanced scan, but the splenic vein or superior mesenteric vein was not shown. When the patient has AHVS, the hepatic veins can be seen on the diaphragm’s understratum during the arterial phase. Interventional treatment: TACE treatment with 76 cases, TAI 30 cases. Of the 70 APS patients, 22 were high and 48 were low. Steel ring + gelatin sponge + chemotherapy for 10 cases, gelatin sponge + 66 cases of chemotherapy, chemotherapy alone in 10 cases. Conclusions: In clinic, DSA combined with CT can detect the existence of arteriovenous shunt in patients with liver cancer. In addition, DSA can also determine the flow and nature of the shunt and the location of the shunt. In the follow-up intervention Treatment to provide some reference.