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目的 :分析腹腔动脉与肠系膜上动脉侧支循环通路假性闭塞的原因和价值。方法 :由两名有经验的介入放射学医生共同回顾性分析 15例该类患者的肠系膜上动脉造影 ,腹腔动脉造影及介入治疗资料 ,并达成一致意见。结果 :15例假性闭塞中 ,临床基础病变包括原发性肝癌 12例 ,肝血管瘤 3例。假性闭塞位于肝总动脉与腹腔动脉分叉处者 8例 ,肝总动脉分出胃十二指肠动脉支处 6例 ,1例右肝动脉直接起源于腹腔动脉 ,并在其分叉处发生假性闭塞。该假性闭塞于腹腔动脉造影时呈闭塞状态 ,而肠系膜上动脉造影却完全通畅 ,似静脉瓣样 ,并且导丝、导管能够顺利通过该闭塞处。结论 :这一少见现象可能与其血液动力学改变和解剖学变异有关 ,了解此征象对于指导介入插管有一定价值。
Objective: To analyze the causes and the value of the pseudo-occlusion of celiac artery and superior mesenteric artery collateral circulation. Methods: Two experienced interventional radiologists retrospectively analyzed the data of 15 cases of superior mesenteric artery angiography, celiac artery angiography and interventional therapy and reached an agreement. Results: Among 15 cases of pseudo-occlusion, 12 cases of primary liver cancer and 3 cases of hepatic hemangioma were found in clinical basis. Pseudo occlusion in the common hepatic artery and celiac artery bifurcation in 8 cases, the common hepatic artery gastroduodenal artery branch in 6 cases, 1 case of right hepatic artery originated directly in the celiac artery, and at its bifurcation Pseudo occlusion occurred. The pseudo-occlusion in the celiac artery angiography occlusion, while the superior mesenteric artery angiography is completely open, like a venous valve-like, and the guide wire, the catheter can successfully pass the occlusion. Conclusion: This rare phenomenon may be related to hemodynamic changes and anatomic variations. To understand this sign is of some value in guiding the interventional intubation.