HP No.6 4 HP No.6 4 NTT 1. 1936 1953 Seldinger Seldinger 1956 Odman X Interventional Radiology IVR 1967 Margulis 1964 Dotter 2. 2.1 IVR CT MR IVR 2.2-1 -
HP No.6 4 2.3 feeding artery parasitic supply increased or hypervascularity a tumor vessel b tumor stain c pooling d displacement e encasement f tumor thrombus threads and streaks sign striated vascular pattern g arterio-venous shunt 2.4-2 -
HP No.6 4 0 4.3 2002 SCHERING 2.5 IVR IVR Vascular IVR Non Vascular IVR IVR Vascular IVR a b TAE TAE transcatheter arterial embolization c TIPS transjugular intrahepatic portosystemic shunt B-RTO balloon-occluded retrograde transvenous obliteration d TAI transcatheter arterial infusion Non-vascular IVR percutaneous transhepatic biliary drainage PTBD percutaneous ethanol injection therpy PEIT PMCT RFTA Vascular IVR DSA a b c remasking pixel shift post processing - 3 -
HP No.6 4 3. 4 3.1 Fig.1 12 1 celiac trunk 12 2 superior mesenteric artery a. 1 2 renal a. 2 3 inferior mesenteric a. 4 common iliac a. 5 1 external iliac a. internal iliac a. Fig.1 1 2 3 4 5 6 7 8 intercostal a. subcostal a. inferior phrenic a. lumber a. middle adrenal a. testicular ovarian a. - 4 -
HP No.6 4 3.2 Fig.2 splenic a. left gastric a. common hepatic a. gastroduodenal proper hepatic a. left hepatic a. middle hepatic a. right hepatic a. supplementary a. replaced hepatic a1 1 accessory hepatic a cystic a. Fig.2 1 2 3 4 5 6 7 8 9 10 11 12 13 posterior superior pancreaticoduodenal a. PSPD anterior superior pancreaticoduodenal a. ASPD gastoroepiploica a. Fig.3 dorsal pancreatic a. great pancreatic a. caudal pancreatic a. transverse pancreatic a. short gastric a. superior polar a. - 5 -
HP No.6 4 Fig.3 1 6 2 7 3 8 4 9 5 Fig.4 1 8 2 9 3 10 4 5 11 12 6 13 Prepancreatic Arterial Arcade 7-6 -
HP No.6 4 3.3 Fig.5 portal vein 1 Couinaud 8 Cantlie line 4 Cantlie line Fig.5 1 2 3 4 Umbilical point UP 5 S2 6 S3 7 8 9 S6 10 S7 11 S5 12 S8 3.4 Fig.6,7 inferior pancreaticoduodenal a. middle colic a. ileocolic jejunal a. ilial a. arcade arcade 3.5 Fig.8,9 ventral branch dorsal branch segmental a. interlobar a. arcuate a. interlobular a. capsular a. 3-7 -
HP No.6 4 Fig.6 1 2 3 4 5 6 7 Fig.7 Fig.8 1 2 3 4 5 6 7 8-8 -
HP No.6 4 3.6 Fig.10 end a. Fig.9 S sigmoidal a. superior rectal a. Fig.10 1 2 3 S 4 3.7 2 4 5 3 / - 9 -
HP No.6 4 3.8 Fig.11 IVR a b c d e f g h 3.9 Fig.11 IVR 4. 4.1 Table1 23 SCHERING DSA 2/3 1/2 4Fr DSA Table2-10 -
HP No.6 4 IVR DSA Table1 Table2-11 -
HP No.6 4 4.2 Fig.12 2 10 20 99.5% n-butyl cyanoacrylate NBCA IDC interlocking detachable coil GDC guglielmi detachable coil ethanolamine oleate EO Ivalon polyvinyl alcohol foam Fig.12 1 2 1 2 3 4 5 3 4 5 4.3 hepatocellular carcinoma HCC TAE CT MR US CT MR US PACS - 12 -
HP No.6 4 2 E1 AV AP Fig.13 2 3 8 7 HCC TAE Fig.14,15,16 Table2 US Angiography CO 2 Fig.13-13 -
HP No.6 4 Fig.14 HCC S7 S8 Fig.15 HCC S7 S8 1 2 3 4 5 Fig.16 HCC S3-14 -
HP No.6 4 vascularity TAE TAI Fig.17 TAE DA Fig.18 AngioCT Multistar TOP/PLUS+SOMATOM PLUS4 Volume Zoom HCV HBV + Fig.17 MMC Pre Post TAE Fig.18 TAE S3-15 -
HP No.6 4 CT 3 HCC PEIT RFTA TAE Fig.19 Angio CT Angio CT CT DSA 2 DSA CTAP CT during arterial portography HCC Fig.19 DSA CTA CT arteriography CTAP Iopamiron300 3 3ml/ 80ml 30 CTA 1.5 3ml/ 5 7 3 Fig.20 HCC CTAP CTA TAE CT Fig.21,22 CTAP CT A CTA CTA Fig.20 S7,8 HCC AngioCT - 16 -
HP No.6 4 CTAP CT Fig.21 TAE S3 CT Pre Post TAE Fig.22 TAE S1,4 CT Fig.23 CTAP MIP 30mm 5. IVR IVR 2 IVR CT - 17 -
HP No.6 4 I.I. X 6. IVR IVR IVR 1. 15 2. 1 991 3. 1992 4. Interventional Radiology 1994 5. X 1996 6. 1997 7. IVR 1998 8. 1999 9. 10. IVR 2002 11. 23-18 -