多层螺旋CT在肝转移性肿瘤射频消融治疗及疗效评估中的价值  

Multislice Spiral CT Value in the Treatment and Efficacy Evaluation of Radiofrequency Ablation in Liver Metastasis of Tumor

作　　者：李建生[1] 凌国辉[1] 汤日杰[1] 卢斌贵[1] 彭俊琴[1] 

机构地区：[1]广州医学院附属肿瘤医院放射科,510095

出　　处：《现代医用影像学》2012年第6期409-412,共4页Modern Medical Imageology

摘　　要：目的:探讨多层螺旋CT在肝脏转移性肿瘤射频消融治疗及术后疗效评估中的价值。材料与方法:本组47例肝转移瘤患者,其中结肠癌17例,直肠癌12例,胃癌9例,鼻咽癌5例,卵巢癌3例;胆囊癌1例。均经手术病理证实。在多层螺旋CT导引下肝转移瘤病灶进行射频治疗,术中观察射频后瘤体CT值及邻近组织情况,术后CT复查了解肿瘤变化。结果:(1)多层螺旋CT引导对于86个病灶给予准确定位及穿刺引导;直观观察消融情况。(2)射频治疗后瘤体内CT值减低,部分瘤灶内见气化灶。(3)复查CT表现为瘤体缩小,增强扫描为无强化略低密度影。(4)术后3个月复查CT示,显效者69个病灶,有效者12个病灶,总有效率94.18%;无效者5个病灶。随访6～12个月,14个病灶出现局部复发(16.28%),7例出现肝内新发转移灶;1年生存率91.45%。结论:多层螺旋CT可以准确定位、引导肝转移瘤的射频消融治疗,评估病灶是否完全破坏;术后复查能够准确评估疗效。Purpose:To explore multislice spiral CT value in the treatment and efficacy evaluation of radiofrequency ablation in liver metastasis of tumor.Materials and Methods:The group of 47 cases of patients with liver metastases,including 17 cases of colon cancer,2 cases of rectal cancer,nine cases of gastric cancer,five cases of nasopharyngeal carcinoma,three cases of ovarian cancer;one cases of gallbladder cancer.Were confirmed by pathology.Multislice CT-guided radiofrequency ablation of liver metastases lesions,observed intraoperative radiofrequency lesions CT value and proximity to the organization,postoperative CT scans to understand tumor changes.Results:(1)Multi-slice CT guidance give accurate positioning and puncture guide for the 86 lesions;observed ablation situation.(2) CT values within the lesion after radiofrequency treatment to reduce part of the lesions were seen in the gasification shadow.(3) Review the CT scan showed tumor regression,enhanced scan showed no enhancement slightly low density.(4) Review 3 months after surgery CT showed markedly effective in 69 lesions,effective in 12 lesions,the total efficiency of 94.18%;invalid 5 lesions.Followed up for 6 to 12 months,14 lesions had local recurrence(16.28%),seven cases of intrahepatic new metastases;1-year survival rate of 91.45%.Conclusion:Multislice spiral CT can accurately locate and guide radiofrequency ablation of hepatic metastases,the assessment of the lesion is completely destroyed;reexamination after an accurate assessment of efficacy.

关 键 词：多层螺旋CT 肝转移瘤 射频消融术 

分 类 号：R735.7[医药卫生—肿瘤]