磁共振导向技术在乳腺癌射频消融治疗中的应用  

Application of interventional MRI in radiofrequency ablation of breast cancer

作　　者：赵玉年[1] 沈文荣[1] 李健[2] 俞乔[2] 郭震[1] 邓荣[2] 唐金海[2] 秦建伟[2] 王慧华[1] 

机构地区：[1]江苏省肿瘤医院影像科,江苏南京210009 [2]江苏省肿瘤医院乳腺外科,江苏南京210009

出　　处：《实用放射学杂志》2017年第7期1088-1091,1099,共5页Journal of Practical Radiology

基　　金：江苏省条件建设与民生科技专项资金项目（BL2014090）.

摘　　要：目的 探讨MRI引导下经皮射频消融（RFA）对乳腺癌治疗的应用价值.方法 12例经穿刺病理确诊的乳腺癌患者,临床分期Ⅳ期7例（肺转移6例,骨转移1例）;Ⅲ期5例（患者因严重高血压、糖尿病或肝肾功能不全,为手术禁忌或年龄大拒绝手术）.全部患者经4~6周期化疗或内分泌治疗及靶向治疗等综合治疗后乳腺残留病灶难以进一步缩小,影像学检查乳腺病灶残存,再次穿刺病理活检证实有活性肿瘤组织细胞残存,遂对乳腺残存病灶行RFA治疗.术后1、3、6、12个月临床随访,3、6、12个月影像学复查.结果 本组12例患者行18次RFA,治疗后MRI检查示肿瘤病灶均发生坏死,瘤内血供消失,无强化区;术后3、6、12个月MRI复查病灶消失,原瘤区无血供,无强化区;6个月及1年X线检查显示原乳腺病灶模糊或者消失.乳腺病灶影像学检查全部达到完全缓解（CR）,有效率为100%.术后随访1年所有患者均生存.结论 磁共振介入技术对乳腺癌RFA治疗安全有效.Objective To evaluate the efficacy of interventional MRI in radiofrequency ablation （RFA）of breast cancer.Methods 12 patients with breast carcinoma proven by core-needle biopsy-were enrolled in this study.Among them, 7 patients were in phase Ⅳ（6 with lung metastasis, 1 with bone metastasis）,and 5 patients were in phase Ⅲ（all of them rejected the surgical operation because of various contraindications,including severe hypertension,diabetes mellitus,liver or kidney dysfunction,and advanced age）.Moreover, all of the tumor size could not be further shrunk after medical treatment （such as 4-6 cycles chemotherapy, endocrine therapy or targeted therapy）.Additionally,breast lesions were still remained to be confirmed by imaging examination and biopsy pathology.Then the tumor and surrounding breast tissue were ablated with radiofrequency,followed by clinical follow-up and imaging examination after 1, 3, 6 and 12 months.Results All the patients completed 18 times RFA treatment.MRI showed that all the tumor lesions were necrotic, blood supply was disappeared and therewas no enhancement.Radiographic examination showed the original breast lesions were fuzzy or disappeared.All the tumors were achieved complete remission （CR） examined by imaging,and the effective rate was 100%.All the postoperative patients survived 1 year according to the follow-up data.Conclusion Interventional MRI is safe and effective method in the radiofrequency ablation of breast cancer.

关 键 词：乳腺癌 磁共振成像 射频消融 

分 类 号：R737.9[医药卫生—肿瘤] R445.2[医药卫生—临床医学]