CT导向氩氦刀冷冻治疗肺部肿瘤影像学表现研究  

The Study of Imaging Manifestation of Lung Neoplasm Treated with Argon-Helium Cryoablation under CT-guided

作　　者：李宝平[1] 周云芝[2] 尹晓明[3] 王洪武[2] 曾庆玉[1] 霍健伟[1] 常鑫[1] 

机构地区：[1]北京煤炭总医院影像科,北京100028 [2]肿瘤微创治疗中心,北京100028 [3]北京煤炭总医院肿瘤微创治疗中心,北京100028

出　　处：《实用放射学杂志》2007年第2期190-193,210,共5页Journal of Practical Radiology

摘　　要：目的研究CT导向经皮穿刺氩氦刀靶向治疗肺部肿瘤后影像学变化，临床疗效及预后。方法CT引导经皮肺穿刺氩氦刀靶向治疗肺癌及肺转移瘤96例。结果96例中，肺癌82例，肺转移瘤14例，共110个病灶。氩氦刀共治疗103次，平均每次治疗1．06个病灶。肿瘤直径1．2～15cm，平均（4．0±2．5）cm。直径〈4cm的肺内63个肿块显效率100％，直径4～6cm的肺内24个肿块，显效率95．8％，直径〉6cm的23个肺内肿块，显效率69．6％。肺部肿瘤冷冻后CT表现病灶处开始可见逐渐增大的低密度类圆形冷冻区，冷冻区中心CT值为负值。随着氩氦刀冷冻治疗后时间延续，大部分肿块较前比较有不同程度的缩小或消失，P〈0．001。术后12月CT追踪了81个病灶，肿块完全消失（CR）16个（19．8％），缩小（PR）42个（51．9％），稳定（NC）17个（21％），增大（PD）6个（7．4％），总有效率为92．6％。结论CT检查对肺部肿瘤氩氦刀靶向治疗后疗效的评价及预后判断有重要参考价值。Objective To evaluate the imaging findings,clinical effect and prognosis of lung neoplasm after treatment with Argon - Helium cryoablation under CT - guided. Methods 96 cases of lung cancer （ 82 cases） and lung metastasis （ 14 cases） were treated with percuta- neous Argon - Helium targeted cryoablation under CT - guided. Results Among 96 cases{ 110 lesions} ,total 103 times of treatment with Ar - He cryoablation （ average 1.06 lesions at one time were done. The diameter of tumors was 1.2 cm to 15 cm （ mean 4.0 cm ± 2.5 cm）. The effective rate was 100% in 63 lesions with diameter less than 4 cm,95.8% in 24 lesions with 4 -6 cm diameter,69.6% in 23 lesions with diameter more than 6 cm. On post - treatment CT,the progressive enlarged round refrigerant low density within tumors could be seen at beginning,the CT value of the center of refrigerant area was negative. Most of the lesions were decrease in size in different degree or disappeared with the time passed after Ar- He cryoablation,P 〈0. 001.81 lesions were followed -up for 12 months by CT examination,among them, 16 （ 19.8% ） were complete response（ CR） ,42 lesions（51.9% ） were partial response（ PR） ,17 lesions（21% ） were no change（ NC） and 6 lesions（7.4% ） enlarged （ PD）. The total effective rate was 92.6%. Conclusion CT study in lung neoplasms after treatment with CT - guided Ar - He cryoablation is of very importance in the evaluation of clinical effect and prognosis.

关 键 词：肺 肿瘤 氩氦刀 体层摄影术 X线计算机 

分 类 号：R734.2[医药卫生—肿瘤] R814.42[医药卫生—临床医学]