肝脏肿瘤微波消融后MRI信号演变解读

发布时间：2018-04-20 10:00

本文选题：微波 + 消融　；参考：《介入放射学杂志》2017年04期

【摘要】：目的对肝脏恶性肿瘤微波消融(MWA)术后MRI信号随时间的演变进行解读。方法 56例患者共56个肝肿瘤病灶,在MWA术后第2天、1个月、6个月行上腹部MRI平扫及增强扫描。观察不同时间点消融区T1WI、T2WI、DWI及增强扫描的信号变化,并判断是否存在肿瘤复发。结果 MWA后2 d,消融区在T1WI、T2WI序列表现为靶样结构,T1WI表现为中央高信号的消融坏死区与周围环绕的低信号带,T2WI表现为低信号的消融坏死区及周围环绕的高信号带;术后1个月及6个月消融区体积萎缩,T1WI及T2WI仍可见靶样结构,T1WI显示消融坏死区信号升高。增强扫描显示MWA后2 d,消融区周围存在异常高灌注,术后2 d、1个月及6个月消融坏死区均无强化。DWI序列显示消融后2 d,消融区周围反应性信号增高,术后1个月及6个月信号逐渐降低。结论肝脏肿瘤MWA术后消融区信号变化是随时间演变的过程,对消融区MRI信号的正确解读有助于疗效判断及方案制定。
[Abstract]:Objective to interpret the evolution of MRI signal with time after microwave ablation of liver malignant tumor (MWA). Methods 56 patients with 56 liver tumor lesions were performed at second days, 1 months and 6 months after MWA, and MRI scan and enhanced scan were performed at 6 months. The changes of T1WI, T2WI, DWI and enhanced scan were observed at different time points. Results the tumor recurrence was 2 d after MWA, the ablation area was in T1WI, the T2WI sequence was the target structure, the T1WI showed the low signal zone of the central high signal ablation necrosis area and the surrounding surrounding, the T2WI showed the low signal ablation necrosis area and the surrounding high signal zone; the ablation area was atrophied at 1 months and 6 months after the operation, and the target samples were still visible in T1WI and T2WI. T1WI showed an elevated signal in the ablation necrosis area. The enhanced scan showed 2 d after MWA, abnormal high perfusion around the ablation area, 2 d after operation, 1 months and 6 months in the ablation zone without enhanced.DWI sequence, 2 d after ablation, a higher signal of reactive signal around the ablation area, and a gradual decrease in the 1 months and 6 months after the operation. Conclusion liver tumor MWA after operation. The change of ablation area signal is a process of evolution over time. The correct interpretation of MRI signal in ablation area is helpful to the judgement of curative effect and formulation of the plan.

【作者单位】：南京医科大学第一附属医院介入放射科;
【分类号】：R445.2;R735.7

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