结核病与肺部健康杂志 ›› 2013, Vol. 2 ›› Issue (1): 14-18.

• 论著 • 上一篇    下一篇

226例肺部恶性肿瘤射频消融治疗后早期CT随访研究

胡牧,刘磊,钱坤,陈东红,刘宝东,支修益   

  1. 100053 北京,首都医科大学宣武医院 首都医科大学肺癌诊疗中心
  • 收稿日期:2013-03-01 出版日期:2013-03-30 发布日期:2013-03-30
  • 通信作者: 支修益,Email:xiuyizhi@yahoo.com.cn

The early image follow-up of CT scan after treatment with radiofrequency ablation of 226 cases lung malignant neoplasm

HU Mu, LIU Lei, QIAN Kun, CHEN Dong-hong, LIU Bao-dong, ZHI Xiu-yi   

  1. Xuanwu Hospital Capital Medical University,Lung Cancer Center Capital Medical University, Beijing 100053, China
  • Received:2013-03-01 Online:2013-03-30 Published:2013-03-30
  • Contact: ZHI Xiu-yi, Email:xiuyizhi@yahoo.com.cn

摘要: 目的观察分析肺部恶性肿瘤患者射频消融治疗后早期CT影像改变。方法选择2007年3月至2010年12月因肺部恶性肿瘤于本院行CT引导下射频消融治疗患者226例,共计消融瘤灶233个,分析评价治疗后瘤灶的CT影像改变。患者中原发性肺癌201例,肺转移癌25例。接受射频消融的瘤灶直径最小1.00cm,最大10.60cm,平均(4.36±2.45)cm。平均随访时间 13.61个月(范围1~30个月)。CT影像改变的评价由3名影像科医生和3名胸外科医生共同完成。结果最常见的CT表现是治疗后立即出现消融瘤灶周围肺组织内磨玻璃样改变,共有215例患者(95.13%,215/226)发生, 多在1个月内吸收;191患者(84.51%,191/226)治疗后瘤灶立即出现增大,127例患者(56.19%,127/226)消融瘤灶内多发小空泡形成;51例患者(22.57%,51/226)空洞形成;121例患者(65.05%,121/186)在术后1个月随访时,胸部CT扫描提示病灶有增大;66例(46.15%,66/143)、57例(50.89%,57/112)患者分别在术后3、6个月CT复查时病灶缩小。结论射频消融瘤灶周围的磨玻璃样改变、空洞及多发小空泡形成,以及胸膜改变是射频消融治疗后最常见的CT所见。射频消融术后1个月内病灶多表现为增大,治疗后6个月病灶缩小。CT是射频术后评估疗效的有效手段之一。

Abstract: Objective The purpose of this study is to describe and analyze the CT appearance of lung neoplasms after treatment with radiofrequency ablation (RFA).Methods The imaging of 233 pulmonary lessions treated by RFA in 226 patients with thoracicneoplasms were followed up. Two hundred and one neoplasms were primary lung cancer and 25 were metastases. The mean pretreatment neoplasm size was (4.36±2.45)cm (range, 1.00-10.60cm). The mean time of follow-up was 13.61 months (range, 1-30months). Imaging findings on CT were evaluated by three radiologists and thoracic surgeons by consensus.Results The most common finding immediately after treatment was peripheral ground-glass opacity surrounding the treated neoplasm, seen in 215 patients (95.13%,215/226). This lesion rapidly resolved by the end of the first month. 127 tumors (56.19%,127/226) developed bubble lucencies after ablation. Cavitation was seen in 51 tumors (22.57%,51/226) on follow-up CT and was more common in the bigger neoplasms. Malignant pleural effusions were usually seen after 3 months. One hundred and twenty-one tumors (65.05%,121/186) enlarged from pretreatment CT scans with follow-up imaging at 1 month. At 3 and 6 months after RFA, 66 cases (46.15%,66/143) and 57 cases (50.89%,57/112) tumors decreased in size. Then the percentage became to drop.Conclusion Conclusion peripheral ground-glass opacity, cavitation, and bubble lucencies are common findings on CT after RFA. Cavitation was more common in bigger neoplasms. Many treated neoplasms increased in size from baseline within 1 month. At 6 month, they decreased in size most obviously. Enlargement of a treated tumor after 6 months is regarded as tumor progression. CT scan is one of the effective methods to evaluate the lung neoplasm after RFA.