肺恶性肿瘤氩氦刀术后CT表现及其变化特点的分析研究

发布时间：2018-05-28 03:24

本文选题：肺肿瘤 + 经皮冷冻疗法　；参考：《临床放射学杂志》2017年10期

【摘要】：目的探讨肺部恶性肿瘤氩氦刀术后多个时间点CT表现及其变化特点。方法前瞻性于术前、术后1天、1周、1个月、3个月、6个月、12个月对接受氩氦刀治疗的26例肺部恶性肿瘤患者(共29个结节)行CT平扫和双期增强扫描,包括14例单发肺癌患者和12例共15个结节的肺转移瘤患者。两名阅片者独立阅片,测量最大横截面积和平扫及增强CT值,配对t检验比较相邻时间点病灶大小和CT值差异,并观察有无空洞、边缘低密度环和并发症。结果 12个月随访周期内总体治疗有效率为86.2%(25/29)。术后1个月,10个(34.5%)消融区内形成空洞。术后1天,16个(55.2%)消融区边缘形成气体样低密度环,并在术后3个月吸收。有效组术后消融区面积持续缩小,术后平扫CT值逐渐下降且无明确强化。4个PD组病灶表现为面积增大,平扫CT值增高并强化,未见空洞和边缘低密度环征象。结论消融区面积逐渐缩小,平扫CT值持续下降且增强扫描CT值增幅15 HU,术后消融区边缘存在低密度环、空洞形成等有助于判断病灶进展,CT在识别消融区及动态反映其变化方面具有重要价值。
[Abstract]:Objective to investigate the CT features of multiple time points after argon-helium surgery for lung malignant tumors. Methods Twenty-six patients (29 nodules) with lung malignant tumor treated with argon-helium knife were examined with plain CT and dual phase enhanced CT scan, one week, one month, three months, six months and 12 months after operation, before operation and 1 day, 1 month, 3 months, 6 months and 12 months after operation. There were 14 patients with single lung cancer and 12 patients with 15 nodules of lung metastases. The maximum cross-sectional area and enhanced CT values were measured. The size of lesions and CT values at adjacent time points were compared by paired t-test, and the cavity, marginal low density ring and complications were observed. Results the overall effective rate during 12 months follow-up was 86.2% 29%. One month after operation, 10 patients had cavities in the ablation area. On the 1st day after operation, 16 (55. 2) gas-like low-density rings were formed at the edge of the ablation area and absorbed 3 months after operation. In the effective group, the area of ablation area continued to shrink, and the CT value of plain scan decreased gradually without definite enhancement. In 4 PD groups, the lesion area increased, the CT value of plain scan increased and enhanced, and there were no signs of cavity and marginal low density ring. Conclusion the area of ablation area gradually shrinks, the CT value of plain scan decreases continuously and the value of enhanced CT increases 15 HU. there is a low density loop on the edge of ablation area after operation. Cavity formation is helpful to judge the progression of lesions and CT is of great value in identifying ablation areas and dynamically reflecting their changes.
【作者单位】：郑州大学附属肿瘤医院(河南省肿瘤医院)放射科;
【基金】：国家自然科学基金面上项目资助(N0.81372370)
【分类号】：R730.44;R734.2

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