Diagnosis and treatment of hepatic blood tumor
Hepatic blood tumor diagnosis and treatment, the diagnosis of hepatic hemangioma depends on the imaging studies. Is a B-body non-invasive, inexpensive, easy to implement screening method, the diagnosis of both qualitative and greater value, the liver hemangiomas preferred method of examination.
CT examination of hepatic hemangioma has obvious characteristic, their diagnosis of vascular tumor rate of 95%, the CT diagnosis of hemangioma of great value. MRI (magnetic resonance imaging) and liver blood pool radionuclide flow phenomenon of a hemangioma in the liver characterized by the patient also has diagnostic significance.
Hepatic arteriography or percutaneous puncture of the hemangioma liver tumor has a good location and qualitative effect of the former are still capable of understanding the blood supply of vascular tumors of the development programs in operation has important reference value. However, invasive examinations, such inspection to have some pain and complications, puncture guided by ultrasound in B, the normal liver tissue, usually in other examinations the diagnosis can not be used.
Hepatic hemangioma is a benign tumor of the liver, rarely malignant, and most of hemangioma , small size, do not cause symptoms, so this hemangioma (diameter less than or equal to 5 cm or no clinical symptoms) can be reviewed at the clinic on a regular basis without treatment.
If the tumor is larger than 5 cm in diameter, and the obvious clinical symptoms (as abdominal pain, oppression adjacent organs, causing abdominal discomfort, abdominal distension, anorexia, nausea, congestive heart failure, coagulation disorder, red blood cells, since cells thrombocytopenia, etc.), vascular tumor during the follow-up increased, those who can not clearly benign or malignant tumor (regardless of tumor size), or patients strongly demand, you need surgical exploration.
Surgical resection of hepatic cavernous hemangioma safe, effective, less recurrence, is the treatment of hepatic cavernous hemangioma of the best methods. But for multiple diffuse hemangioma, special anatomical location, close to the second hepatic portal and vena cava and other large vessels, and surgical risk, and elderly patients, patients can not tolerate surgery and the lack of necessary medical conditions, are not easily make this in operation, and can be taken to other therapies.
Not suitable for surgical resection of the liver hemangioma, other treatments can be taken:
(1) banding surgery hemangioma: resection compared in terms of vascular tumors, hemangioma tied, surgical operation is relatively simple, much less operative risk, surgery is relatively safe, less bleeding, shorter operative time, for small diameter 15 cm hepatic hemangioma, especially in multiple primary tumors after resection of hemangiomas smaller residual tumor or other incidental finding on abdominal surgery, vascular tumors. The liver is too crisp, or near important anatomical structure of hemangiomas is not suitable for such surgery. However, such surgery in terms of relative after hemangioma resection to recurrence.
(2) hepatic artery ligation plus radiation therapy: for multiple diffuse, lesions significantly or near important anatomic structures (such as large blood vessels) unresectable cases, postoperative recurrence is the main problem is easy.
(3) RF ablation: this treatment method is suitable for small tumors of the liver hemangiomas, excessive radio frequency treatment of hemangiomas is not easy to form when the local temperature, poor efficacy. In addition, the neighboring large vessels of hemangiomas due to vascular blood flow can be localized heat away, is not conducive to the formation of local high temperature, it is not suitable for radio frequency treatment of such cases. Under direct vision during surgery, extrusion of blood vessel tumors, the tumor compressed smaller, then block the hepatic blood flow, implementation of radio frequency treatment to obtain more satisfactory results.
Hepatic blood tumor diagnosis and treatment, in addition, one by one intervention selective hepatic artery embolization, for diameter greater than 5 cm hemangioma effect of poor, and prone to serious complications, and the possible formation of collateral circulation after embolization more difficult for future surgery. It has not been generally accepted clinical.