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文章首先描述了肝癌形成肝动静脉瘘(HAVF)的原因,并造成肝细胞癌容易侵犯门静脉、肝静脉而形成动静脉瘘。可造成门静脉高压,加速肝细胞癌(HCC)的肝内播散和肝外转移,给治疗带来一定的难度和危险。在详细介绍超声、多层螺旋CT(MSCT)、数字减影血管造影术(DSA)诊断HAVF不同的影像表现和分型基础上,客观分析了不同诊断方法存在的优劣之处,总结出DSA诊断HAVF有一定特征性表现。因此,DSA被看作是诊断HAVF的“金标准”。治疗方面,中晚期肝癌在没有手术指征的情况下多数选择介入栓塞治疗。对于肝癌合并HAVF的介入治疗方法有很多种。对肝癌合并HAVF的病灶处理不但为肝癌本身治疗提供比较好的治疗基础,对合并门静脉高压或并发消化道出血的治疗也有比较明确的治疗价值,采用微波治疗后瘘口消失的现象有待进一步的观察和研究。
The article first described the formation of hepatic arteriovenous fistula (HAVF) causes of liver cancer, and cause liver cancer easily infringe the portal vein, hepatic vein and the formation of arteriovenous fistula. Can cause portal hypertension, accelerate the hepatocellular carcinoma (HCC) disseminated and extrahepatic metastasis, to the treatment of a certain degree of difficulty and danger. Based on the detailed description of different imaging manifestations and classification of HAVF by ultrasound, MSCT and DSA, the advantages and disadvantages of different diagnostic methods are objectively analyzed, and the DSA Diagnosis of HAVF has a certain characteristic performance. Therefore, DSA is considered as a “gold standard” for diagnosing HAVF. Treatment, the treatment of advanced liver cancer in the absence of indications of the majority of cases involved in the choice of embolization. There are many interventional treatments for HCC with HCC. The treatment of hepatocellular carcinoma with HAVF not only provides a good therapeutic basis for the treatment of HCC itself, but also has a clear therapeutic value for the treatment of complicated portal hypertension or concurrent gastrointestinal bleeding. The disappearance of the fistula after microwave treatment needs further observation And research.