超声引导下射频消融治疗肝转移瘤的疗效观察  

Efficacy of ultrasound-guided percutaneous radiofrequency ablation of hepatic metastases

作　　者：汤丽丽[1] 程文[1] 李龙[1] 韩雪[1] 邵华[1] 

机构地区：[1]哈尔滨医科大学附属第三医院超声科,黑龙江哈尔滨150081

出　　处：《中国介入影像与治疗学》2011年第3期167-170,共4页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的评价超声引导下射频消融(RFA)治疗结直肠癌肝转移瘤(MLC)的疗效。方法采用超声引导下RFA治疗结直肠癌MLC患者60例134个病灶,其中91个病灶≤3.0 cm,43个>3.0 cm。术前39例血清癌胚抗原(CEA)增高,21例正常。采用CEUS检查结合增强CT、穿刺活检及CEA值的动态变化综合评价肿瘤治疗效果。结果术后3个月复查CEA,37例增高,23例正常。术后30 min CEUS检查显示127个射频消融病灶呈无灌注区,近期有效率达94.78%(127/134)。术后1个月CEUS检查显示8个病灶局部增强,考虑复发,经超声引导下穿刺活检及细胞学检查证实而行第2次治疗。术后1个月增强CT复查显示126个(126/134,94.03%)射频消融病灶呈无灌注区,为完全坏死的转移病灶;部分坏死病灶为8个,与CEUS结果一致。结论超声引导下RFA是治疗MLC的一种安全有效的局部微创治疗方法。Objective To investigate the efficacy of ultrasound-guided radiofrequency ablation（RFA） of metastatic liver carcinomas（MLC）.Methods Sixty patients with 134 MLCs who underwent ultrasound-guided RFA were retrospectively analyzed.Among 134 MLCs,91 were smaller than 3.0 cm,43 were larger than 3.0 cm in diameter.The serum carcinoembryonic antigen（CEA） obviously increased in 39 patients and normal in 21 patients.Contrast-enhanced ultrasound（CEUS）,contrast-enhanced CT,biopsy pathology and CEA were used to evaluate the therapeutic efficacy.Results The serum CEA increased in 37 patients and normal in 23 patients 3 months after RFA.Thirty minutes after RFA,CEUS showed no enhancement in 127 lesions,thus the complete ablation rate was 94.78%（127/134）.One month later,residual enhancement was noticed in 8 lesions that identified as recurrence with biopsy,and the second RFA was performed.The complete ablation of the tumor revealed on the follow-up enhanced CT scans after RFA in 126 lesions（126/134,94.03%）.Residual tumor enhancement demonstrated in the remaining 8 lesions,being similar to the results of CEUS.Conclusion Ultrasound-guided RFA is a safe,effective and minimally invasive method for the treatment of MLC.

关 键 词：导管消融 结直肠肿瘤 肿瘤转移 

分 类 号：R735.7[医药卫生—肿瘤]