螺旋CT对射频消融治疗肝脏恶性肿瘤的疗效评价

目的　探讨螺旋CT在肝脏恶性肿瘤射频消融治疗后随访过程中的价值。方法　对 3 6例超声引导下经皮穿刺射频消融治疗的肝脏恶性肿瘤患者 (2 9例原发性肝癌和 7例转移性肝癌 )定期进行螺旋CT双期增强扫描检查 ,观察射频消融的效果及肿瘤复发的情况。结果　肿瘤残留或原位复发的主要征象是消融区的边缘呈带状或结节样强化 ,或在随访CT复查中 ,肿瘤的体积不断增大。在射频消融治疗后的首次CT复查中 ,2 8例 (77.8% )肿瘤出现完全坏死。在随后的CT随访复查中 ,2例 (5.6% )出现肝内原位复发 ,4例 (11.1% )出现肝内异位复发。结论　对于合适的肝脏恶性肿瘤 ,射频消融是一种疗效确切的肿瘤局部治疗方法 ,在其疗效评价和长期随访过程中 ,螺旋CT双期增强扫描是有效的影像检查手段

The Evaluation of Helical CT for Malignant Hepatic Tumors with Radio-frequency Ablation Therapy(RFA)

Objective To assess the role of helical CT in the long-term follow-up of patients with malignant hepatic tumors treated with RFA. Methods CT findings of patients with liver malignant tumors (29 hepatocellular carcinomas and 7 metastases) were reviewed retrospectively, who underwent percutaneous ultrasound-guided radiofrequency ablation (RFA). CT images consisted of nonenhanced and dual-phase contrast-enhanced helical CT scan, the effect of ablation therapy and tumor recurrence were detected. Results The major patterns of tumor residual or local recurrence were the lesions with thick rim or nodular peripheral enhancement in arterial phase or the lesions with gross enlargement on follow-up CT images. The complete necrosis lesions in 28 cases (77.8%) were seen on the initial postablation CT scans after a single session RFA. On the subsequent follow-up CT examination, the local intra-hepatic tumor recurrences were seen in 2 cases (5.6%) as well as the remote intra-hepatic tumor recurrences were seen in 4 cases (11.1%).Conclusion For certain patients with hepatic malignant tumors, RFA is an effective therapeutic method, and dual-phase contrast enhanced helical CT scans play a important role in long-term assessment and follow-up of patients.