肝癌射频消融术后MRI表现及疗效

发布时间：2018-11-05 13:33

【摘要】：目的经皮穿刺射频消融(RFA)广泛应用于肝癌的治疗,本研究分析肝癌RFA术后的MRI表现及疗效,以提高肿瘤的完全消融率。资料与方法回顾性分析7 9例(共11 4个病灶)肝癌患者经皮R FA术后的M R I表现,包括R FA术后1个月、4个月及7个月的病灶大小、信号变化及强化情况;分析术后消融灶两种不同MRI T1WI高信号环表现及肿瘤局部复发率。结果肝癌RFA术后1个月病灶周边在T1WI呈高信号,T2WI呈稍低信号,病灶范围较前稍增大,增强扫描病灶周围呈薄层均匀环形强化,中心区无强化;术后4个月病灶大小相对稳定,病灶周围强化减弱;术后7个月病灶范围较术前缩小,病灶未见明显强化。肝癌复发者,消融灶T1WI高信号环不完整,不完整区增强扫描动脉期呈结节状强化,延时期大部分呈稍低信号,呈"快进快出"的强化特点。T1WI高信号环完整组与不完整组术后7个月复发率分别为6.12%、43.75%,差异有统计学意义(P0.05)。T1WI高信号环完整组总生存率及无瘤生存率均较T1WI高信号环不完整组高,差异有统计学意义(P0.05)。结论肝癌经皮穿刺RFA术后的MRI检查具有特征性的表现,通过T1WI高信号环的完整性及动态增强扫描的表现能早期提示肝癌RFA术后的疗效,指导临床尽早选择治疗方案。
[Abstract]:Objective to evaluate the application of percutaneous radiofrequency ablation (RFA) in the treatment of hepatocellular carcinoma (HCC). Materials and methods the M R I findings of 79 patients with hepatocellular carcinoma (114 lesions) after percutaneous R FA operation were retrospectively analyzed, including the lesion size, signal changes and enhancement at 1 month, 4 months and 7 months after R FA. Two kinds of MRI T1WI high-signal loop manifestations and local recurrence rate of tumor were analyzed. Results 1 month after RFA, the peripheral lesions of HCC showed high signal intensity in T1WI, while T2WI showed a slightly lower signal intensity, and the range of lesions was slightly larger than that of the former. The enhancement scan showed a thin uniform circular enhancement around the lesion, but no enhancement in the central area. At 4 months after operation, the size of the lesion was relatively stable, and the enhancement around the lesion was weakened, but at 7 months after the operation, the area of the lesion was smaller than that before operation, but no obvious enhancement was found. In patients with recurrence of liver cancer, the T1WI hyperintense loop was incomplete, and the incomplete area was nodular enhancement in arterial phase, most of which were slightly low signal intensity in extended stage. The recurrence rate of T1WI high signal loop intact group and incomplete group was 6.12 and 43.75, respectively. The overall survival rate and tumor-free survival rate of T1WI high signal loop complete group were higher than that of T1WI high signal ring incomplete group (P0.05). Conclusion the MRI examination after percutaneous puncture RFA for hepatocellular carcinoma has characteristic features. The integrity of high signal loop of T1WI and dynamic enhanced scan can early indicate the curative effect of RFA and guide the clinical treatment as early as possible. [WT5 "HZ] [WT5BZ] [WT5" HZ] [WT5 "BZ] [WT5" BZ]
【作者单位】：福建医科大学附属三明第一医院CT室;
【分类号】：R445.2;R735.7

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