22例肺癌射频消融术后的CT随访观察

摘要

目的:探讨CT引导下射频消融术(RFA)治疗肺恶性肿瘤的局部疗效及安全性,并总结消融病灶CT随访的演变规律.方法:对22例肺癌病灶(原发灶16例,转移灶6例)进行RFA治疗,病理诊断均为肺腺癌,病灶大小7 ～37 mm,中位数为23 mm.记录RFA术后并发症发生情况,利用多层螺旋CT进行随访并评价疗效,记录消融灶大小及血供变化.结果:所有病例无严重并发症发生.CT随访时间14 d～4年,中位数为10个月.随访3个月以上的病例共18例,16例消融灶无复发,2例消融灶复发.病灶RFA治疗后CT复查表现为随时间延长呈逐渐缩小趋势且无强化,消融灶可形成空洞,随访中增大或出现异常结节样强化提示肿瘤复发,RFA治疗后3个月评价肿瘤灭活情况较可靠.结论:CT引导下射频消融治疗肺癌安全、有效、创伤小,能够作为不能耐受手术患者治疗的选择之一,是一种效果明确的局部减瘤手段.%Aim:The aim of this study was to evaluate the security and therapeutic value of CT guided radiofrequency ablation (RFA) in the treatment of lung cancer,and to find the CT features after RFA in follow-up.Methods:Twenty-two patients with pulmonary neoplasms were underwent CT guided RFA therapy.All lesions were adenocarcinoma,which were composed of 16 cases of primary lesion and 6 cases of secondary lesion.Tumor sizes were 7 mm ～ 37 mm(median was 23mm).The therapeutic effects and complications after RFA were accessed by spiral CT scanning,including the changes of the size and blood supply.Results:All cases did not occur severe complications.The time of CT follow-up was from 14 days to 4 years (median was 10 months).There were 18 cases were followed up over 3 months,and 2 lesions recurred among the 18 cases.The size of lesion after RFA decreased gradually with time prolong,and no enhancement was found in ablation focus,and the cavity appeared in some cases.The size increased and irregular or nodule enhancement were showed when tumor recurred.Three month was regarded as a suitable time to judge tumor activity after RFA.Conclusion:CT guided RFA is a safe,effective and minimally invasive procedure for lung cancer.It can act as an alternative option to treat inoperable lung cancer and decrease tumor local burden.