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选择性肝动脉栓塞在良性肝脏肿瘤中的作用。

Role of selective intra-arterial embolization in benign liver tumors.

作者信息

Ferrer Puchol M D, Parra Casado C La, Cervera Araez A, Sala López R, Esteban Hernández E, Cremades Mira A, Ramiro Gandia R

机构信息

Servicio de Radiología, Hospital Universitario La Ribera. Alzira, Valencia, España.

Servicio de Radiología, Hospital Universitario La Ribera. Alzira, Valencia, España.

出版信息

Radiologia. 2017 Sep-Oct;59(5):414-421. doi: 10.1016/j.rx.2017.04.007. Epub 2017 May 24.

Abstract

OBJECTIVE

To present cases of symptomatic benign liver tumors diagnosed and treated with intra-arterial embolization before surgery.

MATERIAL AND METHODS

We present the cases of 7 patients diagnosed with symptomatic benign liver tumors that required treatment: 1 focal nodular hyperplasia, 2 giant cavernous hemangiomas, 1 hepatic adenomatosis, and 3 hepatic adenomas. Once the feeding arteries were identified, tumors were embolized with polyvinyl alcohol particles (500μm-700μm) and then the feeding artery was plugged with coils if there was an arterial pedicle to ensure the total vascular exclusion of the tumor. The surgical intervention took place 4 to 7 days after embolization.

RESULTS

All 7 patients were women (age range, 23-74 years); presurgical intra-arterial embolization was done in 6. In 1 patient with adenomatosis, embolization was done to control intraparenchymal hepatic hemorrhage. In the 6 patients who underwent surgery, the tumor was completely excised and no intraoperative bleeding events or postoperative complications occurred.

CONCLUSIONS

Provided there is a consensus among the multidisciplinary team, embolization is a useful option in the perioperative management of giant and/or symptomatic benign liver tumors.

摘要

目的

介绍术前经动脉栓塞诊断和治疗的有症状良性肝肿瘤病例。

材料与方法

我们呈现了7例被诊断为需要治疗的有症状良性肝肿瘤患者的病例:1例局灶性结节性增生,2例巨大海绵状血管瘤,1例肝腺瘤病,3例肝腺瘤。一旦确定供血动脉,用聚乙烯醇颗粒(500μm - 700μm)栓塞肿瘤,若存在动脉蒂,则用弹簧圈栓塞供血动脉以确保肿瘤完全血管闭塞。栓塞后4至7天进行手术干预。

结果

所有7例患者均为女性(年龄范围23 - 74岁);6例患者术前行动脉栓塞。1例肝腺瘤病患者行栓塞以控制肝实质内出血。6例接受手术的患者中,肿瘤均被完全切除,术中无出血事件发生,术后也无并发症。

结论

如果多学科团队达成共识,栓塞是巨大和/或有症状良性肝肿瘤围手术期管理的一种有用选择。

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