射频治疗肝脏恶性肿瘤的CT评价(附35例分析)  

CT analysis of hepatic cancer after radiofrequency ablation

作　　者：鲍家启[1] 刘爱国[2] 胡克非[1] 潘志立[1] 王悦[1] 王龙胜[1] 汪松[1] 郑磊[2] 惠锦林[2] 沈文琴[2] 

机构地区：[1]安徽省立儿童医院,安徽合肥230054 [2]安徽省新华肿瘤医院,安徽合肥330054

出　　处：《医学影像学杂志》2003年第1期26-28,共3页Journal of Medical Imaging

摘　　要：目的 :应用螺旋CT评价射频治疗肝癌的近期疗效。方法 :对 35例肝癌 35个病灶射频治疗术前、后肿瘤大小、密度的变化、肿瘤凝固性坏死的形态、范围及术后CT增强扫描的特征进行观察。其中术前进行肝动脉碘油及明胶海绵碎块栓塞 2 3例。结果 :35例肝癌射频术后 5min均有增大 ,术前、后肿块最大径分别为 5 .75± 2 .84cm和 6 .2 2± 1 .1 2cm ,统计学无显著性差异 (P >0 .0 5)。病灶CT值术后 5min均减低 ,术前、后病灶CT值分别为 45 .3± 6 .33Hu和 32 .8± 7.83Hu,均有显著性差异 (P <0 .0 5)。术后 5min 94.2 8% (33/ 35)的病灶呈不同程度凝固性坏死。随访 1～ 1 1个月 ,平均随访 4个月 ,71 % (2 5/ 35)病灶较原病灶缩小 ,2 9% (1 0 / 35)病灶扩大 ,病灶CT值减低 1 1Hu±。CT增强 1 0例 ,其中 5例坏死区表现为无强化 ,5例残留灶 /复发灶显示为结节状或花环状强化。结论 :螺旋CT可准确评价肝癌射频治疗的效果 。Objective:To evaluate the last therapy effect of hepatic cancer treated with radiofrequency ablation by spiral CT.Methods:The variety of the tumor size and density before and after radiofrequency ablation,the shape and extent of coagulative necrosis and the characteristics of the CT enhancement scan after treatment were observed in 35 lesions of 35 cases of hepatic cancer.Hepatic artery embolization therapy with lipiodol and gelfoam were performed in 23 cases before treatment.Results:The tumor enlarged after 5 minute of radiofrequency ablation in 35 cases of hepatic cancer. The most diameter of the tumor were 5.75±2.84cm and 6.22±1.12cm before and after treatment,there were no significant difference (P>0.05).The CT value of lesions decreased after 5 minutes of radiofrequency ablation. The CT value of lesions were 45.3±6.32HU and 32.8±7.8HU before and after 5 minutes of radiofrequency ablation,there were significant difference (P<0.05).94.28%(33/35) lesions had coagulative necrosis to a certain extent after 5 minutes of treatment.For 1～11 months of follow up (averaging 4 months),the size of 71% lesions decreased(25/35),29%(10/35) increased,the CT values of all lesions decreased 11HU±.No enhancement in 5 lesions of coagulative necrosis and nodular enhancement in 5 residual lesions were showed in 10 cases of contrast CT scan.Conclusion:CT is a useful method to assess the therapy effect of hepatic cancer treated by radiofrequency ablation.Our results suggested that the effectiveness is improved when radiofrequency ablation combined with hepatic artery embolization therapy using lipiodol.

关 键 词：射频治疗 肝脏恶性肿瘤 CT 疗效评价 

分 类 号：R730.56[医药卫生—肿瘤] R735.7[医药卫生—临床医学]