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·腹部疾病·

肝动静脉畸形影像诊断与介入治疗

作者:陈 斌 邓海辉 谢宗贵 童光东 林 敏 王晓萍

所属单位:深圳市中医院介入治疗室 (广东 深圳 518000)

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摘要

目的 探讨肝动静脉畸形(hepatic arteriovenous malformation,HAVM)影像诊断与介入治疗方法。方法 分析1例 经CT、 MRI、DSA证实的HAVM,结合国内外文献进行影像诊断与介入治疗的回顾性分析。结果 CT、MRI增强扫描可 显示畸形的血管团影;动脉期病变肝段边缘呈楔形或三角形一过性灌注异常强化。DSA能清晰地显示供血动脉、迂 曲的血管团及引流静脉。动脉栓塞后畸形血管团染色消失。结论 CT、MRI增强及DSA 检查能显示HAVM血流动力学改 变的影像学表现;介入栓塞治疗作为一种微创的方法效果可靠,但栓塞材料选用液体栓塞剂更为妥当。

Objective To explore the maging diagnosis and interventional therapy of hepatic arteriovenous malformation. Methods The case was confirmed by CT, magnetic resonance imaging(MRI) and digital subtraction angiography (DSA).Through the literatures reported at home and abroad,the image diagnosis and interventional therapy of this disease were retrospectively analyzed. Results Contrast enhanced CT and MRI scan can display nidus; wedge-shaped or triangle transient hepatic parenchyma enhancement in arterial phase in the edge of the lesion was observed. DSA examination showed that supplying artery, nidus and drainage vein of AVM.After embolization ,the nidus disappear. Conclusions Contrast enhanced CT and MRI scan and DSA can depict the morphologic and hemodynamic characteristics of HAVM. Interventional embolization as a minimally invasive method effect is reliable, but liquid embolic agents would be more appropriate.

【关键词】肝脏; 动静脉畸形;体层摄影术/X线计算机;磁共振成像;数字减影造影术

【中图分类号】R322.4+7

【文献标识码】A

【DOI】10.3969/j.issn.1009-3257.2015.03.020

前言

肝动静脉畸形 ( h e p a t i c a r t e r i o v e n o u s malformation)是一种少见的肝血管畸形,本文通过1 例住院病例经CT、MRI及DSA证实的肝动脉-门静脉畸 形,进行影像诊断与治疗的回顾性分析,旨在提高对 该疾病的认识。