Department of Interventional Radiology, David Geffen School of Medicine at UCLA, 757 Westwood Plaza, Suite 1638, Los Angeles, CA 90095-7437, USA.
Radiographics. 2012 Jul-Aug;32(4):1121-32. doi: 10.1148/rg.324115114.
Effective treatment of unresectable hepatic neoplasms depends on the appropriate identification of tumor arterial supply. Because hepatic tumors derive more than 90% of their blood supply from the hepatic arteries, awareness of common hepatic arterial anatomic variants (e.g., replaced or accessory left or right hepatic artery), as well as parasitized collateral vessels originating from the celiac axis (e.g., right inferior phrenic, omental, and cystic arteries) that can supply hepatic neoplasms-particularly those with a surface location-is important for safe and effective interventional therapy for these tumors. Moreover, recognition of certain nonhepatic branches arising from the hepatic arterial circulation is important for optimizing transarterial therapy and blocking the passage of treatment particles into sensitive structures, thereby preventing unwanted clinical sequelae such as gastrointestinal ulceration, skin ulceration or pain, and, rarely, ischemic cholecystitis.
有效的不可切除肝肿瘤治疗取决于对肿瘤动脉供应的准确识别。由于肝肿瘤 90%以上的血液供应来自肝动脉，因此了解常见的肝动脉解剖变异（例如，替代或副左或右肝动脉）以及源自腹腔干的寄生性侧支血管（例如，右膈下、网膜和胆囊动脉）非常重要，这些血管可以为肝肿瘤（特别是位于表面的肿瘤）提供供血，对于这些肿瘤的安全有效的介入治疗至关重要。此外，识别来自肝动脉循环的某些非肝分支对于优化经动脉治疗和阻止治疗颗粒进入敏感结构也很重要，从而防止出现胃肠道溃疡、皮肤溃疡或疼痛等不良临床后果，极少数情况下还可防止发生胆囊炎。
