肝癌射频治疗的CT影像分析

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目的 :CT评价集束电极射频治疗肝癌的早期效果。方法 :采用CT增强扫描对 45例肝癌患者集束电极射频治疗前后肿瘤大小和密度的变化、肿瘤凝固性坏死区的范围及治疗后增强扫描的特征进行观察。结果 :集束电极射频治疗后 30d ,45例肝癌患者 5 7个肿块进行CT复查 ,2 8% (16 /5 7)的肝癌病灶缩小 ,47% (2 7/5 7)的肝癌病灶大小无变化 ,2 5 % (15 /5 7)的肝癌病灶较术前增大 ,与治疗前相比无统计学差异。治疗后≤ 5cm的病灶增大占 2 9% (9/31) ,>5cm的病灶增大占 2 3 % (6 /2 6 )。病灶的CT值均减低约 15HU左右 ,与治疗前相比有统计学差异 (P <0 .0 5 ) ,71.9% (41/5 7)的病灶呈完全凝固性坏死 ,增强扫描表现为坏死区域无强化。结论 :CT对肝癌集束电极射频治疗前后肿瘤的大小和密度变化以及肿瘤凝固性坏死大小的观察 ,给肝癌射频治疗效果及预后提供重要指标 ,为重复治疗提供依据 Objective : To evaluate the early results of radiofrequency ablation of liver cancer with CT in the treatment of liver cancer. Methods : CT scanning was used to observe the change of tumor size and density before and after radiofrequency ablation in 45 patients with hepatocellular carcinoma, the range of tumor coagulation necrosis area and the features of enhanced scanning after treatment. RESULTS: After 30 days of radiofrequency treatment with clustered electrodes, 45 cases of 45 cases of hepatocellular carcinoma were examined by CT. 28% (16/5/5) of the lesions were reduced, and 47% (2 7/5 7) of the size of the lesions did not change. 25% (15/5/5) of hepatocellular carcinoma lesions increased compared with preoperative, and there was no statistical difference compared with before treatment. After treatment, lesions with ≤ 5cm accounted for 29% (9/31) and lesions with >5cm accounted for 25% (6/26). The CT values ​​of the lesions were reduced by about 15 HU, which was statistically different from that before treatment (P 0.05), 71.9% (41/5 7) of the lesions showed complete coagulative necrosis, and the enhanced scan showed a necrotic area. No strengthening. Conclusion : CT observation of tumor size and density before and after radiofrequency ablation of liver cancer and observation of the size of coagulation necrosis of tumors provide important indicators for the therapeutic effect and prognosis of hepatocellular carcinoma and provide basis for repeated treatment.
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