Roche A
Radiologie interventionnelle, Institut Gustave Roussy, Villejuif.
Bull Acad Natl Med. 1991 Oct;175(7):1121-7; discussion 1127-8. doi: 10.1016/0959-8049(95)95557-m.
Oncology represents a very wide field of applications in interventional radiology. Procedures are diagnostic as well as therapeutic; approaches may be endovascular (either arterial or venous), endocanalar, or transcutaneous; guidance may need X-ray, sonographic, CT scan or endoscopic control. Such a diversity in methods makes clinical and technical training especially long. Main indications of endoarterial approaches are: pain, bleeding, abnormal secretion (endocrine tumors and paraneoplastic syndrome), abnormal function (kidney, spleen), preoperative devascularization of tumors, redistribution of arterial flows before intra arterial chemotherapy, chemoembolizations. Venous pathology is known to be particularly frequent in oncology. Current indications are inferior vena cava filter placement, angioplasty and stenting in case of superior vena cava syndrome, local fibrinolysis, foreign bodies extraction. Drainages, stenosis dilations and stent placements are daily procedures in urinary and biliary tracts in order to treat obstructions, sepsis or fistulas. Transcutaneous approaches under radiological guidance allow biopsies, drainage of deep collections, antalgic nerve infiltrations, gastrostomy. Nowadays, interventional radiology can be considered as a requisite weapon for a correct cancerous patient management, since it is useful from the initial diagnostic biopsy to the palliative care of cancer complications.
肿瘤学是介入放射学应用非常广泛的领域。操作包括诊断性和治疗性的；途径可以是血管内的（动脉或静脉）、管腔内的或经皮的；引导可能需要X射线、超声、CT扫描或内镜控制。方法的这种多样性使得临床和技术培训特别漫长。动脉内途径的主要适应证有：疼痛、出血、异常分泌（内分泌肿瘤和副肿瘤综合征）、异常功能（肾脏、脾脏）、肿瘤术前去血管化、动脉内化疗前的动脉血流重新分布、化疗栓塞。静脉病变在肿瘤学中尤其常见。目前的适应证有下腔静脉滤器置入、上腔静脉综合征时的血管成形术和支架置入、局部纤溶、异物取出。引流、狭窄扩张和支架置入是泌尿系统和胆道治疗梗阻、脓毒症或瘘管的日常操作。在放射学引导下的经皮途径可进行活检、深部积液引流、止痛神经浸润、胃造口术。如今，介入放射学可被视为正确管理癌症患者的必备手段，因为它从最初的诊断性活检到癌症并发症的姑息治疗都很有用。
