Kanazawa S, Douke T, Yasui K, Mitani M, Sato S, Ajiki M, Kohno Y, Kimoto S, Hiraki Y
Department of Radiology, Okayama University Medical School.
Nihon Igaku Hoshasen Gakkai Zasshi. 1992 Oct 25;52(10):1408-16.
Hepatic arteriography with and without temporary segmental hepatic vein occlusion was performed in 10 patients, five of whom had chronic liver injury. Hepatic arteriograms obtained during hepatic venous obstruction demonstrated significantly more peripheral and definite arterial branches in the occluded area and fewer peripheral branches in the non-occluded segment. A prolonged, dense hepatogram (sinusoidogram) showing hepatofugal opacification of the portal vein was obtained in the occluded area. Only one case with a large veno-venous anastomosis did not show these findings. Hepatic arteriograms in two cases with hepatocellular carcinoma provided clear visualization of peripheral portal branches that could act as efferent tumor vessels during regional temporary hepatic vein occlusion. Temporary hepatic venous occlusion may cause a sudden increase of hepatic arterial flow in the occluded area and transsinusoidal arterioportal communication there. This method can be useful for the diagnosis and arterial infusion or embolization therapy of hepatic diseases.
对10例患者进行了有无暂时性节段性肝静脉闭塞的肝动脉造影,其中5例有慢性肝损伤。肝静脉阻塞期间获得的肝动脉造影显示,闭塞区域的外周和明确的动脉分支明显增多,未闭塞节段的外周分支减少。在闭塞区域获得了延长的、浓密的肝造影图(窦状隙造影图),显示门静脉的肝外分流显影。只有1例有大的静脉-静脉吻合的病例未显示这些结果。2例肝细胞癌患者的肝动脉造影清晰显示了外周门静脉分支,在区域性暂时性肝静脉闭塞期间,这些分支可作为肿瘤的输出血管。暂时性肝静脉闭塞可能导致闭塞区域肝动脉血流突然增加以及该区域的经窦状隙动门脉交通。该方法对肝脏疾病的诊断和动脉灌注或栓塞治疗可能有用。