影像学检查在辅助确定皮肤肿瘤手术切缘中的应用进展

目前对于皮肤肿瘤的治疗仍首选手术切除,手术中在尽量做到切净肿瘤的同时,最大限度的保留正常皮肤,因此对准确界定肿瘤边缘提出了更高的要求.尽管Mohs显微描记手术可以准确界定肿瘤边缘,但Mohs显微描记手术因其耗时多,费用高,过程繁琐等缺点限制了在临床的推广.近年来荧光染色、皮肤CT以及皮肤镜等影像学检查的快速发展,恰好解决了这一难题.研究证实,这些影像学检查在皮肤肿瘤切除术中可以起到辅助确定肿瘤边缘的作用,临床上有助于确定术前及术中肿瘤边界,最终使得手术结果可以同时达到治疗和美观的要求.尤其是皮肤镜、光动力荧光染色和皮肤CT技术相比于Mohs显微描记手术有着创伤小、操作简单、费用低等优点,因此在临床上更容易普及,具有广泛的应用前景.

Application of imaging examination in auxiliary determination of surgical margins in skin tumor surgery

At present,surgical resection is still the first-choice treatment of skin tumors.During the surgery,tumor tissues should be resected as completely as possible,meanwhile the surrounding normal skin should be preserved to the maximum extent.Thus,a higher demand for accurate determination of surgical margins has been put forward.Although Mohs micrographic surgery can accurately determine surgical margins,time consume,high costs and complicated process have limited its clinical promotion.In recent years,with the rapid development of fluorescence staining,cutaneous computed tomography and dermoscopy,this difficult problem has been solved.Studies have demonstrated that the above mentioned imaging examinations can play an auxiliary role in the determination of surgical margins in the skin tumor surgery,help to determine the preoperative and intraoperative tumor margin in clinic,and finally get the goal of good therapeutic and cosmetic effects.Compared with Mohs micrographic surgery,dermoscopy,photodynamic fluorescence staining and cutaneous computed tomography have many advantages of less injury,simple operation and low costs,thus these imaging examinations can be popularized more easily in clinic,and have a broader prospect for clinical application.