[1]徐守军,杜端明,刘鹏程,等. 肝肿瘤射频消融术后CT表现及其临床意义[J].介入放射学杂志,2014,(01):69-73.
　XU Shou? jun,DU Duan? ming,LIU Peng? cheng,et al. CT manifestation and its clinical significance of liver tumors after radiofrequency ablation[J].journal interventional radiology,2014,(01):69-73.
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 肝肿瘤射频消融术后CT表现及其临床意义 ()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
期数:
2014年01期
页码:
69-73
栏目:
临床研究
出版日期:
2014-01-20

文章信息/Info

Title:
 CT manifestation and its clinical significance of liver tumors after radiofrequency ablation
作者:
 徐守军;  杜端明;  刘鹏程;  罗莉丽;  干芸根
Author(s):
 XU Shou?蛳 jun;  DU Duan?蛳 ming;  LIU Peng?蛳 cheng;  LUO Li?蛳 li;  GAN Yun?蛳 gen.
 Department of Radiology， Shenzhen Children’s Hospital， Shenzhen 518026， China
关键词:
 ; 【关键词】 肝肿瘤;  消融技术;  CT
文献标志码:
A
摘要:
【摘要】 目的 探讨肝肿瘤经皮射频消融（RFA）治疗后的CT表现并分析其临床意义，以指导临床治疗。方法 回顾性分析59例（82个病灶）肝肿瘤患者经皮RFA前后的CT影像学资料，分析病灶的大小、密度及强化方式等变化特点。结果 RFA治疗后1个月内完全坏死病灶范围较术前有所增大，呈无强化的低密度影，或呈囊状更低密度影。坏死灶周围常见一层薄而均匀的环形强化，强化特点和正常肝实质基本一致，随着时间的变化逐渐模糊，最终消失。2个月内完全坏死灶范围较术前可略显增大、相仿或略缩小，呈低密度影或更低囊变影。增强扫描无明显强化或动脉期消融区边缘出现一层薄而均匀的环形强化，但较前模糊，显示欠清。2个月以后完全坏死区范围逐渐缩小，增强扫描无明显强化。当肿瘤组织残存时，术后即刻CT显示消融区范围没有完全包括术前病灶的范围，动脉期病灶边缘出现不规则局灶样或结节状强化，门脉期迅速减退，延迟期强化程度低于肝实质，呈“快进快出”特点。如肿瘤复发，病灶局部出现异常强化。血供良好的肿瘤组织显示病灶范围有所增大，动脉期消融区出现局灶样或结节状强化；乏血供的病灶消融区范围较前增大，边缘不光整。结论 肝肿瘤RFA术后的CT检查具有特征性的影像学表现，能有效检出肿瘤的残存或（和）复发，指导临床作出进一步合理、有效的治疗。 

参考文献/References:

 ［1］ Hirohashi S， Ishak K， Kojiro M， et al. Tumours of the liver and intrahepatic bile ducts［M］. Lyon： Iarc Press， 2000： 157 ?蛳 202.
［2］ Bruix J， Sherman M. Management of hepatocellular carcinoma： an update［J］. Hepatology， 2011， 53： 1020 ?蛳 1022.
［3］ Kudo M， Okanoue T. Management of hepatocellular carcinoma in Japan： consensus?蛳 based clinical practice manual proposed by the Japan Society of Hepatology［J］. Oncology， 2007， 72 Suppl 1： 2 ?蛳 15.
［4］ 明建中， 曾志斌， 钟文新， 等． 肝癌射频消融术后CT表现及临床价值［J］． 罕少疾病杂志， 2009， 16： 8 ?蛳 11．
［5］ Schraml C， Clasen S， Schwenzer NF， et al. Diagnostic performance of contrast ?蛳 enhanced computed tomography in the immediate assessment of radiofrequency ablation success in colorectal liver metastases［J］. Abdom Imaging， 2008， 33： 643 ?蛳 651.
［6］ Park MH， Rhim H， Kim YS， et al. Spectrum of CT findings after radiofrequency ablation of hepatic tumors［J］. Radiographics， 2008， 28： 379 ?蛳 390.
［7］ Vanagas T， Gulbinas A， Pundzius J， et al. Radiofrequency ablation of liver tumors（Ⅱ）： clinical application and outcomes［J］. Medicina （Kaunas）， 2010， 46： 81 ?蛳 88.
［8］ Kim KW， Lee JM， Choi BI. Assessment of the treatment response of HCC［J］. Abdom Imaging， 2011， 36： 300 ?蛳 314.
［9］ Clasen S， Rempp H， Boss A， et al. MR ?蛳 guided radiofrequency ablation of hepatocellular carcinoma： long ?蛳 term effectiveness［J］. J Vasc Interv Radiol， 2011， 22： 762 ?蛳 770.
［10］ Niculescu G， Nosher JL， Schneider MD， et al. A deformable model for tracking tumors across consecutive imaging studies［J］. Int J Comput Assist Radiol Surg， 2009， 4： 337 ?蛳 347.
［11］ Bartolotta TV， Taibbi A， Midiri M， et al. Hepatocellular Cancer response to radiofrequency tumor ablation： contrast ?蛳 enhanced ultrasound［J］. Abdom Imaging， 2008， 33： 501 ?蛳 511.
［12］ de Jong G， Hendriks T， Franssen G， et al. Adjuvant radioimmunotherapy after radiofrequency ablation of colorectal liver metastases in an experimental model［J］. Eur J Surg Oncol， 2011， 37： 258 ?蛳 264.
［13］ Orlacchio A， Bolacchi F， Salimbeni C， et al. Heat sink during radiofrequency ablation of a hepatocellular carcinoma abutting a large hepatic cystic lesion［J］. J Vasc Interv Radiol， 2011， 22： 572 ?蛳 575.
［14］ Liu ZY， Chang ZH， Lu ZM， et al. Early PET/CT after radiofrequency ablation in colorectal Cancer liver metastases： is it useful？［J］. Chin Med J （Engl）， 2010， 123： 1690 ?蛳 1694.

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备注/Memo

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（收稿日期：２０１3-０5-26） 
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