Preliminary Discussion About Imaging Characteristics And Clinical Application Of Hepatic Artery Digital Subtraction Angiography In Patients With Decompensated Liver Cirrhosis

Objective: To Discuss the imaging characteristics of hepatic arterydigital subtraction angiography (DSA) in patients with decompensated livercirrhosis, and the clinical application value of DSA in the diagnosis ofprimary small liver carcinoma and umbilical cord blood mesenchymal stemcells (UCB-MSCs) orthotopic liver transplantation.Methods: A retrospective analysis method was used on the134patientswith decompensated liver cirrhosis in the department of gastroenterology,General hospital of Chengdu Military Command, from April2009to April2011, all of them underwent DSA and UCB-MSCs orthotopic livertransplantation.58patients without liver cirrhosis and29patients withprimary carcinoma of the liver, at the same period be in hospital,respectively as the controls, all of them underwent DSA.We summarizedimage and clinical data, analysed the data with Statistical software SPSS13.0.Results:①Compared with the patients without liver cirrhosis, wefound that the blood vessel diameter of hepatic artery branch at all levels inpatients with decompensated liver cirrhosis to be thicker (P<0.01), the bloodvessel of patients with decompensated liver cirrhosis was tortuous;Compared with left hepatic artery, we found that the blood vessel diameterof right hepatic artery in patients with decompensated liver cirrhosis to bethicker (P<0.01); We compared the blood vessel diameter of hepatic arterybranch at all levels in patients with liver cirrhosis, the different levels of theliver function (between grade C and grade B),there was no statisticallysignificant difference between them (P>0.05).②13patients (9.7%) withnegative AFP primary small carcinoma of the liver were discovered from134patients with decompensated liver cirrhosis, all of them underwenttranscatheter arterial chemoembolization (TACE),the13cases werefollowed up for1year (1-year survival was92.3%);29patients withprimary carcinoma of the liver underwent TACE in the control group, theywere followed up for1year,11cases died within1year,1-year survivalwas62.1%.③134patients with decompensated liver cirrhosis underwent136times therapy of UCB-MSCs orthotopic liver transplantation, they werefollowed up respectively for0~3months,4~6months,7~12months,0~3months,13~24months, the incidence of excellent was50%,65.0%,52.4%,53.3%,11cases (8.21%) died within1year④The blood vessel diameter of common hepatic artery and the effect of UCB-MSCs orthotopic livertransplantation were the significant positive correlation (r=0.868, P<0.01);The effctive rates of injecting stem cell from right hepatic arterial were67.7%, the effctive rates of injecting stem cell from liver inherent artery orright hepatic arterial were respective50%and31.4%(X2=23.77,P<0.05).Conclusion:①DSA can clearly show morphological changes ofhepatic artery of the patients with decompensated liver cirrhosis, theimaging diagnosis ability in the AFP negative small HCC patients withdecompensated liver cirrhosis of DSA is superior to the conventionalabdominal CT scan and the ultrasonic inspection,1-year survival of thepatients with HCC is significantly enhanced by DSA and TACE in thedisease early.②The liver function of patients with decompensated livercirrhosis can be improved for long a time after UCB-MSCs orthotopic livertransplantation, without major complications.③The blood perfusion ofcommon hepatic artery and the effects of UCB-MSCs orthotopic livertransplantation are closely related; UCB-MSCs orthotopic liver transpla-ntation by choosing the right hepatic artery approach can achieve bettereffects.