肝细胞癌的肝外供血动脉：基于使用血管MDCT系统的动脉内CT主动脉造影图像的研究

Extra-hepatic feeding arteries of hepatocellular carcinoma: An investigation based on intra-arterial CT aortography images using an angio-MDCT system.

作者信息

Takada Ken, Ito Takanori, Kumada Takashi, Toyoda Hidenori, Tada Toshifumi, Sone Yasuhiro, Endo Tokio, Tanaka Keisuke, Kitagawa Hirofumi, Ichikawa Katsuhiro

机构信息

Department of Medical Technology, Ogaki Municipal Hospital, Ogaki, Japan; Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan.

Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Japan.

出版信息

Eur J Radiol. 2016 Aug;85(8):1400-6. doi: 10.1016/j.ejrad.2016.05.007. Epub 2016 May 17.

DOI:10.1016/j.ejrad.2016.05.007

PMID:27423679

Abstract

OBJECTIVES

We investigated the frequencies and factors associated with the presence of extra-hepatic feeding arteries (EHFAs) of hepatocellular carcinoma (HCC) using intra-arterial CT aortography images.

METHODS

A total of 173 patients with HCC who underwent transarterial chemoembolization (TACE) in our institution between January 2013 and March 2015 were enrolled. The types of EHFAs were evaluated by CT aortography images using an apparatus that combines multidetector-row computed tomography and angiography system. In addition, factors associated with the presence of EHFAs were determined.

RESULTS

EHFAs were present in 22 (12.7%) patients with HCC. EHFAs most frequently branched from the right inferior phrenic artery (n=19), while others branched from the right adrenal artery (n=2), right renal artery (n=2), right internal thoracic artery (n=2), branches of the superior mesenteric artery (n=1), and an unknown artery from the aorta (n=1). Factors significantly associated with the presence of EHFAs in multivariate analysis were tumor size≥30mm (odds ratio (OR), 5.233 [95% confidence interval (CI), 1.507-17.413]; p=0.009) and number of prior TACE treatments≥3 (OR, 6.847 [95% CI, 1.928-24.311]; p=0.003).

CONCLUSIONS

EHFAs of HCC were assessed with CT aortography images. Repeat TACE treatments and large tumor size were risk factors for the presence of EHFAs.

摘要

目的

我们使用动脉内CT主动脉造影图像研究了肝细胞癌（HCC）肝外供血动脉（EHFA）的出现频率及相关因素。

方法

纳入2013年1月至2015年3月间在我院接受经动脉化疗栓塞术（TACE）的173例HCC患者。使用结合了多排探测器计算机断层扫描和血管造影系统的设备，通过CT主动脉造影图像评估EHFA的类型。此外，确定与EHFA存在相关的因素。

结果

22例（12.7%）HCC患者存在EHFA。EHFA最常起源于右膈下动脉（n = 19），其他起源于右肾上腺动脉（n = 2）、右肾动脉（n = 2）、右胸廓内动脉（n = 2）、肠系膜上动脉分支（n = 1）以及主动脉的一支不明动脉（n = 1）。多因素分析中与EHFA存在显著相关的因素为肿瘤大小≥30mm（比值比（OR），5.233 [95%置信区间（CI），1.507 - 17.413]；p = 0.009）和既往TACE治疗次数≥3次（OR，6.847 [95% CI，1.928 - 24.311]；p = 0.003）。