钇[90Y]放射性栓塞治疗肝细胞癌后良性胆道狭窄。
Benign Biliary Stricture after Yttrium-90 Radioembolization for Hepatocellular Carcinoma.
机构信息
Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, #101 Daehak-ro, Jongno-gu, Seoul 03080, South Korea.
Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, #101 Daehak-ro, Jongno-gu, Seoul 03080, South Korea.
出版信息
J Vasc Interv Radiol. 2020 Dec;31(12):2014-2021. doi: 10.1016/j.jvir.2020.07.024. Epub 2020 Nov 6.
PURPOSE
To determine the frequency and possible causative factors of benign biliary stricture after radioembolization in patients with hepatocellular carcinoma (HCC).
MATERIALS AND METHODS
This retrospective study comprised 232 patients with HCC who underwent yttrium-90 radioembolization between October 2015 and September 2019. Benign biliary stricture was defined as biliary ductal dilatation of segmental or lobar biliary ducts on follow-up images. Clinical and radiologic characteristics were compared using χ test or independent t test.
RESULTS
Mean target perfused tissue dose was 224.6 Gy ± 106.8 (median, 205.7 Gy; range, 47.0-694.7 Gy). Of 232 patients, 15 (6.5%) had benign biliary stricture, which was detected from 3 weeks to 10.3 months (mean, 3.9 months; median, 3.2 months). Whereas 5 patients did not have any symptoms or signs associated with benign biliary stricture, 10 patients had cholangitis and/or laboratory abnormality requiring biliary drainage procedures and intravenous antibiotic therapy. Selective radioembolization through a caudate artery was performed in 55 (23.7%) patients. The incidence of benign biliary stricture was 16.4% (9/55) and 3.4% (6/177) in patients with and without selective radioembolization through a caudate artery, respectively (P = .002).
CONCLUSIONS
Benign biliary stricture following yttrium-90 radioembolization may be common among patients receiving selective treatment via a caudate artery.
目的
确定肝细胞癌（HCC）患者接受钇-90 放射性栓塞治疗后良性胆道狭窄的频率和可能的致病因素。
材料与方法
本回顾性研究纳入了 2015 年 10 月至 2019 年 9 月期间接受钇-90 放射性栓塞治疗的 232 例 HCC 患者。良性胆道狭窄定义为随访图像上显示的节段性或叶性胆管胆管扩张。采用卡方检验或独立 t 检验比较临床和影像学特征。
结果
平均靶组织灌注剂量为 224.6 Gy ± 106.8（中位数，205.7 Gy；范围，47.0-694.7 Gy）。232 例患者中，有 15 例（6.5%）发生良性胆道狭窄，于 3 周至 10.3 个月（平均 3.9 个月；中位数 3.2 个月）发现。5 例患者无良性胆道狭窄相关症状或体征，10 例患者出现胆管炎和/或实验室异常，需行胆道引流术和静脉抗生素治疗。55 例（23.7%）患者行选择性经尾状叶动脉放射性栓塞治疗。经尾状叶动脉选择性放射性栓塞治疗的患者中良性胆道狭窄的发生率为 16.4%（9/55），未行选择性经尾状叶动脉放射性栓塞治疗的患者中良性胆道狭窄的发生率为 3.4%（6/177）（P =.002）。
结论
接受选择性尾状叶动脉治疗的患者接受钇-90 放射性栓塞治疗后，良性胆道狭窄可能较为常见。
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