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BMC Gastroenterol. 2018 Nov 12;18(1):174. doi: 10.1186/s12876-018-0899-3.

Clinical characteristics of hepatic Arterioportal shunts associated with hepatocellular carcinoma.

Author information

1
Department of Intervention, Shandong Tumor Hospital Affiliated to Shandong University, Jinan, 250117, China.
2
Department of Radiotherapy, Shandong Tumor Hospital Affiliated to Shandong University, Jinan, 250117, China.
3
Department of pathology, Shandong Tumor Hospital Affiliated to Shandong University, Jinan, 250117, China.
4
Department of Thoracic Oncology Surgery, Shandong Tumor Hospital Affiliated to Shandong University, No. 440, Jiyan Road, Jinan, 250117, China. jinanwhy@163.com.

Abstract

BACKGROUND:

Hepatic arterioportal shunt (A-P shunt) is defined as the direct blood flow established between hepatic artery and portal venous system; it is frequently observed in patients with hepatocellular carcinoma (HCC). Clinically, it is important to diagnose HCC associated A-P shunts, as it may impact the treatment strategy of the patients. In the present study, we described the imaging findings of the HCC associated A-P shunts and discussed the treatments strategy of such patients. From the findings, we also discussed the potential cause of A-P shunts.

METHODS:

Clinical data of HCC patients (n = 560), admitted to the hospital between April 2012 to April 2014, were reviewed. Hepatic angiography was used to examine the presence of A-P shunts. Of the 137 patients with A-P shunts, grading of the A-P shunts was performed, and statistical analysis of the different grades of A-P shunts and clinical characteristics was performed.

RESULTS:

The hepatic angiography confirmed that 99 patients had typical A-P shunts (Grade 1-3), and 38 patients had atypical A-P shunts. Embolization was the main strategy used to treat A-P shunts, in which liquid embolic agents appeared to provide a better treatment outcome. The correlation analysis showed that the grading of portal vein tumor thrombus was significantly associated with the grading of A-P shunt (p = < 0.001, Spearman correlation coefficient was 0.816 ± 0.043).

CONCLUSIONS:

We characterized A-P shunts and proposed treatment strategy for treating HCC patients with various levels of A-P shunts. The findings supported the hypothesis that the formation of HCC associated A-P shunts was caused by tumor thrombus.

KEYWORDS:

Hepatic arterioportal shunts; Hepatocellular carcinoma; Portal vein tumor embolus; Transarterial chemoembolization

PMID:
30419830
PMCID:
PMC6233279
DOI:
10.1186/s12876-018-0899-3
[Indexed for MEDLINE]
Free PMC Article

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