C臂CT在15例肺部小病灶射频消融术中的应用  

The application of C-arm CT scanning in performing radiofrequency ablation for small lung lesions:preliminary experience in 15 cases

作　　者：李晓群[1] 张勇[1] 黄大钡[1] 张健[1] 张高尚[1] 文自祥[1] 李记华[1] 刘辉来[1] 

机构地区：[1]中山市人民医院(中山大学附属中山医院)放射影像中心介入室,广东省528403

出　　处：《介入放射学杂志》2013年第1期67-70,共4页Journal of Interventional Radiology

摘　　要：目的探讨C臂CT在肺部小病灶射频消融(RFA)治疗中的应用价值。方法分析C臂CT引导下15例患者16次肺小病灶RFA的穿刺成功率、术后累积生存率、肿瘤缓解率、并发症发生率及辐射剂量。结果 16例次肺小病灶RFA中,18处病灶穿刺成功率为100%。12例出现并发症,包括气胸2例(均无需穿刺抽气或胸腔闭式引流),咯血3例,胸痛7例。15例患者RFA治疗后的6个月生存率为100.0%,1年生存率为69.0%,2年生存率为60.0%。有影像随访记录的15个病灶中,术后第1次复查(1～3个月)显示肿瘤缓解率(CR+PR)为53.3%(8/15)。手术平均累积剂量及平均有效剂量分别为(187.62±108.46)mGy和(5.50±3.31)mSv。结论 C臂CT在肺部小病灶RFA术中能给术者带来丰富的信息,可提高病灶穿刺成功率,是一种值得推广的影像引导技术。Objective To evaluate C-arm CT scanning in performing radiofrequency ablation （RFA） for small lung lesions. Methods A total of 16 times of C-arm CT-guided RFA was carried out in 15 patients with small lung lesions. The puncture success rate, the postoperative accumulated survival rate, the remission rate of the tumor, the occurrence of the complications and the radiation dose were recorded, and the results were analyzed. Results A total of 16 times of RFA were accomplished. The puncture success rate for 18 lesions was 100%. Complications occurred in 5 cases, including pneumothorax （n = 2）, hemoptysis （n = 3）.For the two patients developing pneumotho- rax, neither air suction nor thoracic closed drainage was needed. After RFA, the 6- month, one-year and two-year accumulatedsurvival rate was 100%, 66.0% and 66.0% respectively. Follow-up examination with imaging equipments that was carried out in 1 - 3 months after RFA showed that the remission rate of the tumor（CR ＋ PR） was 53.3% （8/15）. The mean accumulated radiation dose and the mean effective radiation dose were（187.62± 108.46） mSv and （5.50 ± 3.31） mSv respectively. Conclusion In performing radiofrequency ablation for small lung lesions, C-arm CT scanning can provide the operator with plenty of useful information, which is very helpful for improving puncture success rate. Therefore, this technique should be recommended in clinical practice. （J Intervent Radiol, 2013, 22： 067-070）

关 键 词：肺小病灶 C臂CT 射频消融 辐射剂量 

分 类 号：R734.2[医药卫生—肿瘤]