经皮乙醇注射治疗（PEIT）肝细胞癌（HCC）后的门静脉灌注缺损

[Portal perfusion defect after percutaneous ethanol injection therapy (PEIT) for hepatocellular carcinoma (HCC)].

作者信息

Matsushita E, Unoura M, Inagaki Y, Terada M, Notsumata K, Shimizu M, Kaneko S, Kobayashi K, Hattori N, Arai K

机构信息

First Department of Internal Medicine, Kanazawa University.

出版信息

Nihon Shokakibyo Gakkai Zasshi. 1990 Jul;87(7):1537-43.

PMID:2170719

Abstract

Serial changes of intrahepatic portal blood flow were studied before and after percutaneous ethanol injection therapy (PEIT) for hepatocellular carcinoma (HCC). In all eight patients examined, wedge-shaped perfusion defects distal to the tumor were clearly demonstrated by dynamic sequential computed tomography during arterial portography (CT-AP). However, no abnormalities of arterial blood flow were detected in the areas of reduced portal blood flow by enhanced computed tomography (CT), indicating that portal blood flow of the liver was selectively decreased by PEIT. Moreover, histopathological finding of two resected liver tissues after PEIT revealed organized thrombi in the portal veins in the non-cancerous liver tissues distal to the tumors. These findings suggest that decreased segmental portal flow is frequent after PEIT and obstructive vasculitis is caused by the drainage of ethanol injected in the tumor.

摘要

研究了经皮乙醇注射治疗（PEIT）肝细胞癌（HCC）前后肝内门静脉血流的系列变化。在所有8例接受检查的患者中，动脉门静脉造影（CT-AP）期间的动态序列计算机断层扫描清楚地显示了肿瘤远端的楔形灌注缺损。然而，增强计算机断层扫描（CT）未在门静脉血流减少的区域检测到动脉血流异常，表明PEIT选择性地降低了肝脏的门静脉血流。此外，PEIT后两块切除肝组织的组织病理学检查发现，肿瘤远端非癌肝组织的门静脉中有机化血栓。这些发现表明，PEIT后节段性门静脉血流减少很常见，且肿瘤内注射的乙醇引流导致阻塞性血管炎。