肝癌射频消融术后的血管改变与疗效及残癌监控  

The Co-relation between Hepatic Tumor Vessel Variations after RFA and RFA Efficacy,and The Monitor of Residues and Reoccurrences

作　　者：陈永富[1] 伍筱梅[1] 商健彪[1] 赖清[1] 

机构地区：[1]广州医学院第一附属医院放射科,广州510120

出　　处：《现代临床医学生物工程学杂志》2006年第2期111-113,共3页Journal of Modern Clinical Medical Bioengineering

基　　金：广州医学院第一附属医院科研基金资助(200231).

摘　　要：目的 探讨射频消融术（RFA）后肿瘤血管改变与疗效的相关性及残癌的监控。方法 35例肝脏肿瘤41个病灶，在接受RFA术后1-12月行CT、肝动脉及间接门静脉造影检查，根据术后CT及DSA造影表现及临床随访，评估RFA术的疗效，并对残留及再生肿瘤病灶实施介入干预。结果 RFA术后，在12个月的随访中。24个病灶完全坏死；17个病灶出现残留，13个出现肿瘤再生，表现为残留的肿瘤血管和肿瘤染色，以及新生肿瘤血管和不规则新肿瘤染色灶。经过肝动脉化疗和栓塞治疗后，残留和再生病灶得到控制。结论 肝脏肿瘤的供血血管的再通或血管的再生（侧支循环的产生），与肿瘤残留及再生有直接相关性，DSA血管造影应作为监控肿瘤残留的金标准。Objective To study the co- relation between therapeutic efficacy of radiofrequency ablation （RFA） and the variations of tumor vessels in malignant liver neoplasm after RF trestment, and to study the surveillance and control of the residual lesions. Methods 41 malignant hepatic tumor lesions were treated by RFA in 35 patients. CT scan, hepatic arterial angiography and indirect portal vein angiography were performed 1～12 months after RFA procedures. The therapeutic efficacies of RFA were evaluated according to the imaging findings and clinically follow up. Interventioual interference was performed at those cases with residual or recurrent tumors. Results 27 tumor lesions were completely necrotic during the 12 month - follow up. Residual and recurrent lesions were found in other 17 tumors, which were proved by angiography findings of residual tumor vessels, embolized vessels＇ recanalization, tumor stain and tumor angiongenesis. These 17 lesions were controlled by transhepatic arterial chemotherapy and embolization （TACE）. Conclusions Tumor vessel recanalization and angiogenessi after RFA are directively relative to residual or recurrent tumor. Hepatic arterial angiography should applied as the gold criterion for monitoring residues and recurrences.

关 键 词：肝肿瘤 射频消融 血管造影 肝动脉栓塞化疗术 

分 类 号：R735.7[医药卫生—肿瘤]