MR早期评估肝癌微波消融范围的临床研究

发布时间：2018-04-22 05:21

本文选题：微波消融 + 范围　；参考：《介入放射学杂志》2017年01期

【摘要】：目的应用MR早期评估经皮微波消融(MWA)肝脏肿瘤的消融范围。方法 2015年1月1日至2016年1月31日,46例肝脏肿瘤患者[55个病灶,平均直径(26.0±5.3)mm]行CT引导下经皮MWA治疗。消融后第2天,MR评估消融疗效,记录消融范围(长径×短径),与微波厂家提供的参考值进行对比分析,并对消融并发症进行记录分析(消融不足或过度)。结果术后第2天MR显示55个病灶均成功进行MWA治疗,无严重消融后即刻并发症发生。病例分布:60 W 5 min(n=4)、60 W 8 min(n=4)、60 W10 min(n=14)、70 W 8 min(n=4)、70 W 10 min(n=11)、80 W 10 min(n=18),对应的消融范围分别为41.3 mm×31.2 mm、52.0 mm×36.3 mm、51.5 mm×34.3 mm、52.9 mm×35.5 mm、56.8 mm×36.1 mm、64.0 mm×44.0 mm。相比参考值均偏大,其中80 W 10 min组差异最大(64.0 mm×44.0 mm比54.0 mm×37.0 mm,P0.01)。未观察到消融不足病灶,可观察到过度消融病灶12个,主要表现为消融范围累及肝包膜或皮下肌层。结论术后MR早期复查可用于精准评估消融范围,本研究MWA作用范围比参考值大,术前精确预估消融范围有利于肿瘤的完全消融及提高消融的安全性。
[Abstract]:Objective to evaluate the extent of early Mr ablation of liver tumors after percutaneous microwave ablation. Methods from January 1, 2015 to January 31, 2016, 46 patients with hepatic neoplasms [55 lesions with an average diameter of 26.0 卤5.3)mm] were treated with CT guided percutaneous MWA. The ablation effect was evaluated by Mr on the second day after ablation. The ablation range (long diameter 脳 short diameter) was recorded and compared with the reference value provided by microwave manufacturers. The complications of ablation were recorded and analyzed (insufficient or excessive ablation). Results on the second day after operation, 55 lesions were successfully treated with MWA, and no complications occurred immediately after ablation. The distribution of the cases was 60W / 5min ~ (4) ~ (60) W ~ (8) / min ~ (4) ~ 60 W ~ (10) / min ~ (14) ~ 70 W ~ (70) W / min ~ (70) W / min ~ (80) W / min ~ (80) W / min ~ (18) ~ (18) respectively. The corresponding ablation ranges were 41.3 mm 脳 31.2 mm 52.0 mm 脳 36.3 mm ~ 51.5 mm ~ 52.9 mm 脳 35.5 mm ~ 56.8 mm 脳 36.1 mm ~ (60) mm ~ (64) mm ~ (64) mm ~ (64) mm ~ (64) mm 脳 44.0 mm ~ (-1). In 80 W 10 min group, the maximum difference was 64. 0 mm 脳 44. 0 mm vs 54. 0 mm 脳 37. 0 mm P 0. 01. No insufficient ablation focus was observed, and 12 lesions were found in excessive ablation, mainly involving the hepatic capsule or subcutaneous myometrium. Conclusion early Mr examination can be used to evaluate the ablation range accurately. In this study, the range of MWA is larger than the reference value. Accurate preoperative prediction of ablation range is beneficial to complete ablation of tumor and improve the safety of ablation.
【作者单位】：南京医科大学第一附属医院介入放射科;
【分类号】：R735.7;R445.2

【相似文献】