How should hepatic arteriography be performed?

Hepatic artery angiography is a medical examination method for the liver. Generally, hepatic artery angiography can check whether the human body has any disease. It can also check hepatic hemangioma and liver disease, or liver cirrhosis, etc. During hepatic artery angiography, the examination is performed through the blood vessels. This medical examination method can effectively determine the health of the liver.

Hepatic arteriography

Hepatic arteriography can be used for the diagnosis of primary liver tumors, liver metastases, hepatic hemangiomas, adenomas, liver cysts, parasitic liver diseases, cirrhosis, hepatic artery aneurysms, and hepatic arteriovenous fistulas, and can also guide interventional and surgical treatments of liver diseases.

The main manifestations of angiography of liver cancer are the increase in liver cancer blood vessels, disordered direction, and vascular displacement observed in the arterial phase after the injection of contrast agent. In the parenchymal and venous phases, the contrast agent is observed to remain in the tumor area to form tumor staining. The blood supply of the tumor can be judged based on indicators such as the thickness of the tumor's blood supply artery, the number of tumor blood vessels, and the vascular lake.

The presence or absence of satellite lesions can also be determined by observing the deposition of iodized oil through tumor staining and postoperative angiography. The same method can be used to determine whether there are residual lesions in patients after tumor surgery, which is of great significance for guiding the patient's next treatment plan and evaluating changes in the condition before and after surgery.

The main angiographic manifestation of liver metastases is marginal ring-shaped tumor staining in the arterial phase or circular-like light staining in the parenchymal phase, while the tumor blood vessels are normal. The tumor does not have a rich blood supply, and the absence of contrast staining cannot rule out liver metastases.

Hepatic hemangioma often has specific changes, with scattered vascular lakes in the tumor, which are mainly concentrated at the edges. The contrast agent is retained in it for a long time, which can reach more than 20 seconds. Widely scattered vascular lakes can often be seen in the venous phase, and the blood vessels at the edge of the tumor are often compressed and displaced. In the acute phase of liver abscess angiography, only vascular advancement is seen, with no blood vessels in the lesion area; in the subacute and chronic phases, in addition to arterial advancement, congested thick walls can be seen around the abscess, manifesting as a 0.5-1.0 cm high-density band.

Angiography is generally not required for the diagnosis of cirrhosis, but it can help rule out the presence of other lesions, which manifest as a significant reduction in liver volume, irregular edges, and straightening, tortuosity, and uneven thickness of the intrahepatic arteries. Angiography of hepatic artery aneurysm and hepatic arteriovenous fistula can directly show the location and size of the aneurysm and fistula, and can directly perform interventional embolization and fistula closure treatment based on angiography. For those who are ineffective with interventional treatment, surgical treatment can still be considered.

Preparation before the examination

1. Explain the purpose of angiography and possible complications and accidents to the patient and his family, and sign an angiography agreement;

2. Explain the angiography process and precautions to the patient to eliminate concerns and gain cooperation during the operation;

3. Check heart, liver, and kidney functions, as well as blood routine and blood clotting time;

4. Necessary imaging examinations, such as B-ultrasound, CT, etc.;

5. Iodine and anesthetic agents must be handled as required by the pharmacopoeia;

6. Do not eat or drink for 4 hours before surgery, empty your bowels and bladder, and train the patient to hold his breath;

7. Prepare the skin at the puncture site routinely and give sedatives if necessary;

8. Establish intravenous access to facilitate medication and rescue during surgery.