螺旋CT动态增强扫描对原发性肝癌射频消融术后早期效果评价  

The early effect of dynamic spiral CT scan of primary liver cancer after radiofrequency ablation

作　　者：黄志华[1] 吴任泉 邓秋华[1] 余莉[1] 罗晓东[1] 

机构地区：[1]南昌市第九医院放射科,南昌330006

出　　处：《江西医药》2015年第8期738-740,共3页Jiangxi Medical Journal

基　　金：南昌市指导性科技计划项目;洪科发计字【2011】158号

摘　　要：目的分析原发性肝癌射频消融术后螺旋CT动态增强扫描表现,提高术后肝脏局部形态改变的认识,评价其早期疗效。方法按病灶直径将41例原发性肝癌分为两组,直径≤30mm小肝癌25例,直径>30mm16例共41个病灶,经RFA治疗后1-2个月复查CT,分析病灶术后CT表现。结果直径≤30mm小肝癌组术后CT平扫主要表现为更大范围的均匀低密度影,边界较清,以类圆形或不规则形为主,部分可见轻度分叶。增强扫描整体呈均匀低密度,无强化16例;周边环形低密度6例(其中5例于治疗后3-5个月消失,1例病灶扩大、复发);网格状强化2例;局部结节状强化并包膜下积液1例;合并斑点状含气影1例。6个月内复查,2例病灶扩大,1例出现肝内转移。直径>30mm肝癌组RFA治疗后CT平扫表现主要为较原灶等大或更大不规则形或分叶状低密度影,密度欠均匀,边界欠清晰。增强扫描治疗区无强化11例,不均匀强化5例,主要表现为不规则形斑片状强化,2例伴斑点状气体影。6个月内复查,10例病灶扩大或肝内、外出现新发转移灶,肝内转移灶增强后呈"快进快出"或轻度强化改变。结论肝癌RFA术后CT表现多样,与术前病灶直径大小有一定关系,CT可以了解原发性肝癌射频消融早期效果。Objective To analyse the manifestation of dynamic spiral CT of primary liver cancer after radiofrequency ablation,raise awareness of the changesin liver morphology,evaluate its early effect. Methods According to lesion diameter,41 patients were divided into two groups,25 cases by diameter≤30mm,16 by diameter〉 30mm,review CT performance after treating by RFA in 1 month to 2 months. Results The diameter ≤30mm group mainly CT performance was a wider range of homogeneouslow density,with clear boundary,round or irregular in shape,partially lobulated. 16 cases showed an homogeneouslow density with no enhancement in enhanced scan;6 cases showed peripheral low density（including 5 cases who＇s low density disappeared in 3 to 5months,1 case expanded and recured）;2 cases showed reticular enhancement,1 case showed partialnodular enhancement withsubcapsular hydrops,1 case with mottled gas shadows. In 6 months 2 cases enlarged,1 case had liver metastasis. Diameter 30mm group mainly showed the same or larger irregular or lobulated lowdensity,lack of uniform density,less clear boundary. 10 cases showed no enhancement in enhanced scan,6 cases showed inhomogeneous enhancement,mainly manifested as irregular patchy enhancement,2 cases with mottled gas shadow. In 6 months,10 cases enlarged or appeard newmetastases,and enhanced in ＂first in,first out＂ or mild enhancement. Conclusion The CT performance of primary liver cancer after RFA is manifestation,and have acertain relationship with diameter CT can evaluate the early effect of RFA.

关 键 词：原发性肝癌 RFA CT 

分 类 号：R816.5[医药卫生—放射医学]