肝脏恶性肿瘤射频消融术后早期FS-T2WI消融区周围水肿环评价消融疗效的应用  

Application of edema ring around the ablation zone on FS-T2WI of early phase in effect evaluation of radiofrequency ablation for malignant hepatic tumors

作　　者：宋吉慧[1] 王丽娜[1] 权力[1] 王强[1] 徐绍武 艾琦[1] 高宏波[1] 董雷[1] 翁文采[1] SONG Jihui;WANG Lina;QUAN Li;WANG Qiang;XU Shaowu;AI Qi;GAO Hongbo;DONG Lei;WENG Wencai(Department of Radiology,Affiliated Xin Hua Hospital of Dalian University,Dalian 116021,China)

机构地区：[1]大连大学附属新华医院放射科

出　　处：《中国介入影像与治疗学》2019年第6期328-332,共5页Chinese Journal of Interventional Imaging and Therapy

基　　金：大连市医学科学研究计划项目(1711128)

摘　　要：目的探讨肝脏恶性肿瘤射频消融(RFA)术后早期FS-T2WI消融区周围水肿环形态用于评价RFA疗效的价值。方法收集接受RFA治疗的18例肝癌及4例肝转移瘤患者,于术后第3天行MR平扫,观察FS-T2WI中消融区周围水肿环的形态特点;随访复查MR平扫、多期增强扫描及肿瘤标志物,评价根据FS-T2WI水肿环连续性判断RFA疗效的价值。结果消融后,22例病灶FS-T2WI消融区周围均出现高信号水肿环。19例水肿环连续,其中11例厚薄均匀,8例厚薄不均匀但形态规整、边界清晰;术后随访均无异常强化,肿瘤标志物稳定,提示消融完全。3例水肿环不连续,局部可见外凸稍高信号结节,术后1个月增强MRI可见结节状动脉期强化,血清甲胎蛋白升高,提示消融区域未完全覆盖肿瘤区域,消融不完全。结论肝脏恶性肿瘤RFA后早期FS-T2WI消融区周围水肿环对评价疗效具有一定价值,尤其对于判断短期疗效意义重大。Objective To explore the value of edema ring around the ablation zone on FS-T2 WI for early phase effect evaluation of radiofrequency ablation(RFA) for treatment of malignant hepatic tumors. Methods Totally 18 patients with liver cancer and 4 with liver metastasis who underwent RFA therapy were enrolled. Plain MR images were obtained to observe the morphological features of the edema ring around the ablation zone on FS-T2 WI on the third day after RFA. Plain and multiphase enhanced MRI were obtained after RFA to observe the effect, as well as tumor markers. The value of continuity of edema ring on FS-T2 WI for evaluating the effect of RFA was assessed. Results High-signal edema ring was seen around the ablation zone on FS-T2 WI in all 22 cases. The edema rings were continuous in 19 cases, among them the thickness of the edema rings were uniform in 11 cases, while were uneven but with regular shape and clear boundary in the other 8 cases. No abnormal enhancement was detected on the following enhanced MRI after RFA, and the tumor markers were stable in above 19 cases, both suggesting completed ablation. The edema rings were discontinuous in 3 cases of liver cancer, with protruding slightly high signal nodule which enhanced on MRI 1 month after RFA, and the serum alpha-fetoprotein were elevated, suggesting that the ablation area did not completely cover the tumor area, and the ablations were not complete. Conclusion The edema ring around the ablation zone on plain FS-T2 WI early phase after RFA has certain value in assessing the effect of RF for malignant liver tumors, especially for short-term effect of RFA.

关 键 词：肝肿瘤 射频消融 治疗结果 磁共振成像 

分 类 号：R735.7[医药卫生—肿瘤] R445.2[医药卫生—临床医学]