摘要
目的探讨CT联合超声引导下微波消融治疗尾状叶肝癌的临床疗效及安全性。方法回顾性地收集2015年1月~2017年1月我院收治的明确诊断为尾状叶肝癌患者63例,经多学科会诊讨论后,共15例患者行CT联合超声引导下肝癌微波消融治疗。对患者进行随访,随访截止日期为2018年1月;评估治疗效果,主要为局部病灶复发率,以及手术并发症。首次治疗后3个月内每月返院复查一次,若未发现肿瘤复发,则每3个月复查一次,若发现病灶有复发,则再次行消融治疗,复查时通过增强CT、超声造影或增强MR影像学检查明确尾状叶病灶情况。结果 15例均成功完成治疗。平均随访时间为14(8~20)个月。随访时间内15例患者于术后1个月复查完全消融率达到100%;1例于术后2个月尾状叶病灶复发,复发率为6.7%,再次行消融治疗,截止最终随访时间尾状叶病灶未复发,其余14例于随访时间内尾状叶病灶均未复发;15例患者中有1例发生手术相关性4级并发症,发生率为6.7%,其余均为1~2级不良反应。结论 CT联合超声引导下微波消融治疗尾状叶肝癌对尾状叶肝癌的治疗提供了一种新途径,并且具有良好的临床效果和较高的安全性。
Objective To explore the clinical efficacy and short-term curative effect of CT-and ultrasound-guided microwave ablation of caudate lobe liver cancer. Methods From January 2015 through January 2017, 15/63 patients with caudate lobe liver cancer were selected for CT-and ultrasound-guided microwave ablation. All patients were followed up until January 2018 to analyze the therapeutic effect including postoperative complications and tumor recurrence rate. The patients were hospitalized once a month for assessment including contrast-enhanced CT, ultrasound or MRI during the initial three months after ablation. If there was no tumor recurrence, they were hospitalized every 3 month for assessment. If the tumor recurred in the caudate lobe, they under-went ablation once more. Results All 15 patients successfully completed the treatm ent with mean follow-up time of 14（8-20）months. The complete ablation rate was 100% in the first month. In the second month, the recurrence rate was 6.7% with 1/15 re-lapse. After second ablation, the caudate lobe lesions did not recur until the final follow-up. The remaining 14 patients did not re-lapse in the follow-up period. Complication rate was 6.7% with 1/15 patients having grade 4 and 14/15 patients having grade 1-2 complications in the lungs. Conclusion CT-and ultrasound-guided microwave ablation of caudate lobe liver cancer is safe with good short-term curative effect.
作者
陈嵩
庄文权
郭文波
吴志强
CHEN Song;ZHUANG Wen-quan;GUO Wen-bo;WU Zhi-qiang(Department of Interventional Radiology,The First Affiliated Hospitalof Sun Yat-Sen University,Guangdong 510080,China)
出处
《影像诊断与介入放射学》
2018年第3期219-225,共7页
Diagnostic Imaging & Interventional Radiology
