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目的探讨肝癌合并动静脉瘘的DSA表现及介入治疗方法。方法对673例经证实的肝癌患者先行(肠系膜上动脉)间接门脉造影及腹腔动脉或肝总动脉造影,再行肝动脉内灌注化疗和/或栓塞治疗。结果合并动静脉瘘者有151例(22.4%),其中动门静脉瘘127例,动肝静脉瘘有15例,混合型有9例;131例(86.8%)动静脉瘘患者施行了1次或多次肝动脉栓塞治疗,20例因动静脉瘘口不能有效栓塞和/或合并门静脉主干瘤栓而行单纯灌注化疗。结论DSA影像是肝癌合并动静脉瘘直观可靠的诊断方法,肝动脉灌注栓塞治疗是肝癌动静脉瘘患者最有效的治疗方法之一。
Objective To investigate the DSA manifestation and interventional therapy of hepatocellular carcinoma with arteriovenous fistula. Methods Sixty-three patients with confirmed HCC were treated with indirect portal vein angiography and celiac artery or common hepatic artery angiography, followed by intrahepatic arterial infusion chemotherapy and / or embolization. Results There were 151 cases (22.4%) with arteriovenous fistula, including 127 cases of arteriovenous fistula, 15 cases of arteriovenous fistula and 9 cases of mixed arteriovenous fistula. 131 cases (86.8% Multiple hepatic arterial embolization, 20 cases of arteriovenous fistula can not be effective embolization and / or combined with portal vein tumor thrombus and simple perfusion chemotherapy. Conclusion DSA imaging is an intuitive and reliable method for the diagnosis of hepatocellular carcinoma with arteriovenous fistula. Hepatic arterial infusion and embolization is one of the most effective treatment for patients with arteriovenous fistula.