超声引导下肿瘤的氩氦刀治疗  

Ultrasonography Guiding Cryotherapy Using an Argon-Helium Based System for the Tumors

作　　者：贺声[1] 王洪武[1] 张云山[1] 朱世华[1] 贾文凯[1] 沈燕华[1] 辛红[1] 

机构地区：[1]海军总医院超声科,北京100037

出　　处：《中国医学影像技术》2003年第2期216-218,共3页Chinese Journal of Medical Imaging Technology

摘　　要：目的　了解超声在实体肿瘤氩氦刀治疗过程中的引导及观察作用。方法　本组资料的观察对象为 3 6例接受了氩氦刀治疗的肝脏、肺、颈部及乳腺肿瘤患者 ,超声为其提供了术前、术后的肿块观测和术中治疗过程的影像学引导 ,并对有手术前后病理资料的患者的图像变化进行了分析。结果　①冷冻 1min后即可有冰球形成 ,冰球的前缘呈弧形强回声带 ,后方伴有“干净”的声影 ,其后弧形光带逐渐增宽 ,5～ 6min后达到最大 ,冰球内径可达 2 .5～ 3 .0cm ;两把以上的超导刀同时操作时 ,可见冰球的融合图像。②本组多数患者的瘤灶治疗后一周内的径线大小以及内部回声变化不明显 ,少部分瘤灶可见内部及周边血流信号减少 ,瘤灶中央出现液化区 ;手术前后的病理切片表明 ,两个冷冻 溶解循环后 ,肿瘤内可有明确的凝固性坏死灶形成。③无 1例患者发生出血、胆管瘘等并发症。结论　氩氦刀对实体肿瘤组织细胞灭活的效果确实 ,超声引导氩氦刀的治疗过程有助于发挥其最大的冷冻效率。Objective To have a knowledge about ultrasonography guiding cryotherapy using an argon helium based system for the solid tumors. Methods Thirty six patients with malignant tumors in liver,lung and neck as well as breast respectively accepted the cryotherapy using the argon helium based CRYOC system (Endocare,Inc,Irvine,California).The course of percutaneous puncture,location of the probe in the masses,and tumor changes of post cryotherapy were guided and observed by real time ultrasonography. Results ①An iceball with echogenic fronter and sharp shadow behind would appear one minute after the operation had started. As the freeze course progressed,the iceball would reach its biggest diameter of 2.5- 3.0 cm in 5-6 minutes. If multineedle was used,mergence of the iceballs could be imaged. ②Although blood flow signal within the tumor or at the edge of tumor decreased in a few of the patients,most of the tumors did not change obviously in their diameters and inter echo during one week after the cryotherapy. However,there was massive coagulation necrosis among the masses pathologically after a double freeze thaw cycle. ③No complications,such as hemorrhage,biliary fistula ets,occurred in the data. Conclusion As the tumor could be destroyed definitely by cryotherapy using an argon helium based system,using ultrasonic guidance could result in a safe and effective treatment and a marked decrease in complications for the patients.

关 键 词：冷冻疗法 肿瘤 超声成像 氩氦刀 

分 类 号：R445.1[医药卫生—影像医学与核医学] R730.5[医药卫生—诊断学]