肝細胞癌經酒精直接注射後之血管攝影變化

Angiographic Changes of Hepatocellular Carcinoma after Direct Ethanol Injection

曾觀達(Koon-Tat Tsang) ； 曾旭明(Yuk-Ming Tsang) ； 區慧儀(Wau-Yee Au) ； 許金川(Jin-Chuan Sheu) ； 黃冠棠(Guan-Tarn Huang) ； 魏達成(Ta-Cheng Wei) ； 徐劍耀(Jane Chien-Yao Hsu) ； 黃國茂(Kou-Mou Huang)

《中華放射線醫學雜誌》 13卷1期 (1988/03) Pp. 71-77

摘要

本報告分析10例進行超音波導引直接注射99.9%酒精治療肝細胞癌病例之血管攝影變化。四例在術後平均217.5天進行追蹤血管攝影者，腫瘤染色消失只有兩例，另外二例則見肝細胞癌復發。六例在術後平均11.1天進行追蹤血管攝影者除腫瘤染色消失外尚有多樣性之變化。此10例在酒精注射前、後的血管攝影比較中發現經過酒精注射後會出現一些特殊變化，其中腫瘤染色消失不見佔8例，原肝腫瘤變成－放射線透明壞死區域(radiolucent necrotic area)佔4例，程度不一之周邊充血變化(perifocal hyperemic change)佔2例，肝動脈閉塞(occlusion of hepatic artery)佔3例，動脈壁不規則(arterial irregularity)佔2例，此外門靜脈分枝閉塞(occlusion of portal vein)、肝動脈門靜脈間分流(Arterio-portal shunting)、膽囊血管擴張(Engrogement of cystic artery)及線狀空氣紋(Ilnear air streak)各有一例。此些變化與酒精注射量及追蹤間隔有關，注射量多及追蹤間隔短則變化較多樣性及明顯。血管攝影中腫瘤染色消失是治療效果的重要徵候，但卻不能準確地表示出壞死之範圍，同時殘餘結節亦會為肝實質之炎症反應所掩蓋。

關鍵字

血管攝影 ； 肝細胞癌 ； 酒精

並列摘要

We have analysed the angiographic findings of 10 cases of hepatocellular carcinomas before and after treatment by intratumoral injection of absolute ethanol (99.9% Merck Pharmaceuticals, Columbus, Ohio). The result shows less angiographic findings in four cases in an average of 217.5 days after treatment, and more specific angiogarphic changes are noted in the other six cases in an average of 11.1 days after treatment. In the comparison of the angiographic findings before and after intratumoral injection of the 10 cases of hepatocellular carcinomas. The most common finding is the disappearance of the tumor stain in 8 cases. Other angiographic changes include the replacement of the original tumor by a radiolucent necrotic area in 4 cases, perifocal hyperemic change in 2 cases, occlusion of the hepatic artery in 3 cases, and arterial irregularity, occlusion of the portal vein, arterio-portal shunting, engorgement of the cystic artery and linear air streaks in one case for each one.

並列關鍵字

angiography ； hepatocellular carcinoma ； ethanol