多层螺旋CT血管成像对评价肾脏恶性肿瘤血供来源价值.docVIP

多层螺旋CT血管成像对评价肾脏恶性肿瘤血供来源价值【摘要】 目的 研究肾恶性肿瘤肾外供血动脉的来源和形成机制，以指导临床治疗。方法 对116例肾恶性肿瘤患者行多层螺旋CT增强扫描，分析其肾外供血动脉的特征及形成机制。结果 116例患者中42例有肾外供血动脉（共72支），这些患者肿瘤均突破肾包膜；74例无肾外供血动脉，其中41例肿瘤突破肾包膜，33例肿瘤末突破肾包膜，两者差异有统计学意义（χ2=26.18，P＜0.0001）。肾外供血动脉的来源与肿瘤发生的部位有关。结果 明确肾恶性肿瘤肾外供血动脉的来源，对于指导临床治疗具有重要的意义。 【关键词】 肾肿瘤；肾动脉；多层螺旋CT;血管造影 The study of multi-slice CT angiography in the origin of extrarenal arterial blood supply of renal m alignancy and its clinica value MA Xiu-mei,ZHAO Bin,SUN Sheng,et al.School of Medicine,Shandong University,Shandong 250012,China 【Abstract】 Objective To study the origin and mechanisms of extrarenal arterial blood supply of renal malingnancy for its interventional therapy. Methods Enhancement spiral CT scanning were performed in 116 patients with renal m alignancy.The characteristrcs and formation mechanisms of extrarenal arterial blood supply for renal m alignancy were analyzed. Results Of the 116 patients , extrarenal arterial blood supply of renal m alignancy were found in 42 patients and there were 72 branchs. The breakthrough of renal capsule with m alignancy were found in those 42 patients.No extrarenal arterial blood supply of renal m alignancy was found in 74 patients, including 41 patients with and 33 patients without the renal capsule breakthrough with m alignancy.The emerge of extrarenal arterial blood supply of renal m alignancy were significantly different（χ2=26.18，P＜0.000 1）between the patients with and without the breakthrough of renal capsule with m alignancy.The origin of extrarenal arterial blood supply were correlated with the location of the tumor.Conclusion It is important to determine the origin of the extrarenal arterial blood supply in renal m alignancy for its interventional therapy. 【Key words】 Kidney neoplasms; Renal artery; Multi-spiral CT;Angiography 肾动脉栓塞治疗是肾恶性肿瘤的主要治疗手段之一，肿瘤切除术前肾动脉和姑息性肿瘤化疗栓塞已广泛应用于临床，并取得了显著的效果。然而由于部分患者有膈动脉、肾上腺动脉等肾外供血动脉对肿瘤供血，单纯的肾动脉栓塞不能完全阻断肾肿瘤的全部血供，这降低了肿瘤栓塞的疗效，增加了栓塞后再行手术切除的难度。DSA是诊断肾动脉病变的“金标准”，但具有创伤性,且不能明确肾动脉病变的解剖情