Zhao Dan, Xie Lingli, Makamure Joyman, Liu Ziyi, Zhang Lijie, Li Qing, Zhang Xin, Zhao Yazhuo, Zheng Chuansheng, Shi Liangrong, Liang Bin
Department of Radiology, Hubei Province Key Laboratory of Molecular Imaging, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1277 Jiefang Avenue, Wuhan, 430022, China.
Department of Gastroenterology, General Hospital of the Yangtze River Shipping, No. 1 Huiji Road, Wuhan, 430010, China.
Cardiovasc Intervent Radiol. 2024 Jul;47(7):931-942. doi: 10.1007/s00270-024-03690-4. Epub 2024 Mar 20.
To evaluate the safety, efficacy and predictors of response of transcatheter arterial embolization (TAE) to treat hepatic hemangiomas (HHs).
A retrospective analysis was conducted of consecutive HH patients who received TAE with bleomycin-Lipiodol emulsion and gelatin sponge particles at three institutions from January 2014 to January 2021. TAE effectiveness was defined as more than 50% reduction of tumor volume. The effectiveness, safety, and CT changes of hemangiomas after TAE were assessed. Factors affecting TAE efficacy on tumor size were analyzed with logistic regression analysis.
A total of 102 patients with 109 HHs were included. After treatment, both the tumor diameter and volume were significantly reduced from 8.5 ± 3.9 to 5.9 ± 3.8 cm (P < 0.001) and 412.6 ± 742.3 cm to 102.0 ± 232.7 cm (P < 0.001), respectively. TAE effectiveness was achieved in 80.7% (88/109) of hemangiomas, which was characterized by progressive reduction in tumor volume over time with Lipiodol retention. Atypical enhancement pattern (tiny enhancing dots in the hepatic arterial and portal venous phase) (p = 0.001) and central arterioportal shunt (APS) (p = 0.002) associated with the tumor were independent predictors of TAE ineffectiveness. Postembolization syndrome and transient increase in liver enzymes were common without severe complications and death.
TAE was safe and effective in reducing HH size. Lesion enhancement pattern and APS type were associated with TAE efficacy on tumor shrinkage.
Level 3, non-controlled retrospective cohort study.
评估经导管动脉栓塞术（TAE）治疗肝血管瘤（HHs）的安全性、有效性及反应预测因素。
对2014年1月至2021年1月在三家机构接受平阳霉素 - 碘油乳剂和明胶海绵颗粒TAE治疗的连续HH患者进行回顾性分析。TAE有效性定义为肿瘤体积缩小超过50%。评估TAE后血管瘤的有效性、安全性及CT变化。采用逻辑回归分析影响TAE对肿瘤大小疗效的因素。
共纳入102例患者的109个HH。治疗后，肿瘤直径和体积分别从8.5±3.9 cm显著减小至5.9±3.8 cm（P<0.001），从412.6±742.3 cm减小至102.0±232.7 cm（P<0.001）。80.7%（88/109）的血管瘤实现了TAE有效性，其特征为肿瘤体积随时间逐渐缩小且碘油滞留。与肿瘤相关的非典型强化模式（肝动脉期和门静脉期微小强化点）（p = 0.001）和中心动门脉分流（APS）（p = 0.002）是TAE无效的独立预测因素。栓塞后综合征和肝酶短暂升高常见，无严重并发症和死亡。
TAE在减小HH大小方面安全有效。病变强化模式和APS类型与TAE对肿瘤缩小的疗效相关。
3级，非对照回顾性队列研究。
