射频消融联合肝动脉栓塞治疗巨大肝血管瘤的效果评价  

Computed tomography-guided radiofrequency ablation following transcatheter arterial embolization in treatment of large hepatic hemangiomas

作　　者：宋晶晶[1] 赵中伟[1] 涂建飞[1] 纪建松[1] 高君[2] 

机构地区：[1]温州医科大学附属第五医院,丽水市中心医院介入科,323000 [2]首都医科大学附属北京朝阳医院西区肝胆外科,北京100043

出　　处：《中华介入放射学电子杂志》2015年第4期201-206,共6页Chinese Journal of Interventional Radiology：electronic edition

基　　金：北京市卫生系统高层次卫生技术人才培养项目;浙江省丽水市科技计划项目(2012JYZB89)

摘　　要：目的探讨射频消融(RFA)联合肝动脉栓塞(TAE)治疗巨大肝血管瘤(直径≥10 cm)的可行性、安全性及有效性。方法收集我院2007年10月—2015年5月期间,经TAE序贯RFA治疗15例患者15个巨大肝血管瘤的临床资料。回顾性分析其一般资料、RFA治疗策略、消融相关并发症、完全消融率、消融灶直径变化及复发情况等。结果所有患者均成功完成RFA联合TAE治疗。TAE后血管瘤的平均直径从(13.0±2.2)cm缩小至(7.1±2.0)cm。RFA治疗后,14个血管瘤(93.3%)获得完全消融。RFA治疗后1个月,消融灶平均直径缩小至(6.1±2.0)cm;6个月后缩小至(4.9±1.6)cm。15例患者中,4例患者发生了6个消融相关并发症;根据Dindo–Clavien分级,均属轻微并发症(I级)。结论 RFA联合TAE治疗巨大肝血管瘤是安全、有效的;TAE可有效阻断血管瘤血供,使瘤体缩小,降低后续RFA治疗的难度,减少消融相关并发症。Objective The purpose of this study was to evaluate the feasibility, safety, and efficacy of computed tomography （CT）-guided radiofrequency （RF） ablation combined with transcatheter arterial embolization （TAE） to treat large （≥ 10 cm） hepatic hemangiomas. Methods We retrospectively reviewed our sequential experience with 15 large hepatic hemangiomas in 15 patients. Results The mean diameter of the 15 hemangiomas was （13.0±2.2） cm （10.0–16.0 cm）. RF ablation combined with TAE treatment was performed successfully in all patients. The mean diameter of the hemangiomas decreased from （13.0±2.2） to （7.1±2.0） cm fter TAE treatment. Out of 15 hepatic hemangiomas, 14 （93.3%） showed no enhancement on CT or MRI indicating complete ablation after RF treatment. The mean diameter of the ablation zone decreased to （6.1±2.0） cm one month after ablation and further decreased to （4.9±1.6） cm six months after ablation. There were six complications related to the ablation in four patients. According to the Dindo–Clavien classification, all the complications were minor （Grade I）. Conclusions RF ablation combined with TAE is a safe and effective treatment for large hepatic hemangiomas. TAE can improve the disruption of lesion blood supply and reduce lesion size to facilitate subsequent RF ablation and reduce the risk of ablation-related complications.

关 键 词：血管瘤 肝脏 巨大 射频消融 栓塞 

分 类 号：R735.7[医药卫生—肿瘤]