超声引导经皮微波消融治疗肾上腺肿瘤  

A Study of Ultrasound-Guided Percutaneous Microwave Ablation of Adrenal Tumor

作　　者：倪晓霞[1,2] 于晓玲[1] 王旸[1] 程志刚[1] 鲁通[1] 梁萍[1] 

机构地区：[1]解放军总医院介入超声科,北京100853 [2]解放军第306医院超声科,北京100101

出　　处：《中国医学影像学杂志》2011年第3期185-189,共5页Chinese Journal of Medical Imaging

摘　　要：目的观察超声引导经皮微波消融治疗肾上腺肿瘤的安全性和临床疗效。资料与方法 9例肾上腺肿瘤患者(9个病灶),其中肾上腺转移癌5例,肾上腺嗜咯细胞瘤1例,肾上腺非功能性腺瘤3例。肿瘤直径2.0～4.5cm。治疗时在超声引导下将水冷式微波天线置入肿瘤内,肿瘤直径<2cm者使用一根微波天线,肿瘤直径>2cm者使用2根微波天线。邻近肠道的肾上腺肿瘤,在微波辐射时瘤周测温,保持治疗温度<54℃,同时辅以瘤周无水乙醇注射(5～8ml)以增强疗效。微波消融后3d内行超声造影观察有无残存肿瘤,造影无肿瘤残存者于治疗后第1、3个月,随后每3～4个月行增强CT/MR评价肿瘤的治疗效果。结果 8例病灶在1次消融后完全坏死,1例病灶在2次消融后完全坏死,微波消融无严重并发症出现,随访期内未发生肿瘤局部复发。结论超声引导经皮微波消融肾上腺肿瘤安全有效、副作用小,是治疗局限性肾上腺肿瘤的有效方法。Purpose To evaluate the safety and efficacy of ultrasound-guided percutaneous microwave（MW）ablation of adrenal tumor.Materials and Methods Nine patients with pathologically proven adrenal tumor（9 lesions）,including 5 cases of adrenal metastases,1 pheochromocytoma,and 3 non-functional adrenal adenomas.The diameters of the tumors were between 2.0 and 4.5 cm.While treating,water-cooled microwave antenna was inserted into the tumor under ultrasonic guidance.One antenna was used for tumors whose diameter were less than 2 cm,and two antennas for larger than 2 cm ones.As it was for adrenal tumors near the intestine,peritumoral temperature was monitored and treating temperature was maintained below 45℃ during MW,supplemented by peri-tumoral injection of absolute alcohol（5～8ml）to enhance efficacy.Immediate treatment efficacy was assessed by ultrasound within 3 days after MW ablation,to observe whether there were residual tumors.Patients with no residual tumors were treated with enhanced CT/MR for one,three months or every three to four months,and efficacy was eval-uated.Results The lesions in the 8 cases completely turned necrosis after one ablation and those in 1 case was completely ablated after two ablations,withous serious complications.No local tumor recurrence was observed during follow-up period.Conclusion Ultrasound-guided percutaneous MW ablation appears to be a safe and effective treatment with little side effects,for limitative adrenal neoplasms.

关 键 词：肾上腺肿瘤 微波消融 超声引导 

分 类 号：R737.904.51[医药卫生—肿瘤]