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目的探讨使用宽口径1.5TMR设备引导下射频消融(RF)治疗肝脏恶性肿瘤的有效性、成功性和安全性。方法在110例病人中,56个原发性肝癌病变和157个肝转移病变接受了157次经皮射频消融治疗。平均病灶直径为20mm(4～54mm)。所有的治疗计划、程序和介入治疗后监测均在宽口径1.5TMR设备下进行。介入治疗后立即行肝脏MR增强扫描检查对技术的成功性进行评估。通过肝脏的动态MR成像,对消融技术治疗1个月后的有效性进行了研究评估,平均随访时间为24.2个月(范围5～44个月)。结果 210/213个病变(98.6%)达到技术成功和技术有效。18/210病变(8.6%)治疗4～28个月后发生肿瘤局部复发浸润。18个病变中的7个取得二次完全消融治疗,其他6例病变行手术治疗。总体射频消融(RF)有效率为93.4%(199/213),整体治疗成功率(包括手术)为96.2%(205/213)。发生2种严重并发症(1.3%)(出血和感染性胆汁瘤)和14种(8.9%)轻微并发症,其中有157个病变接受了干预措施。结论宽口径MR引导下射频消融治疗肝脏病变是一种安全、有效的治疗方法。
Objective To investigate the effectiveness, success and safety of radiofrequency ablation (RF) guided by wide-bore 1.5TMR device in the treatment of hepatic malignancies. Methods Of the 110 patients, 56 primary liver cancer lesions and 157 liver metastases underwent 157 percutaneous radiofrequency ablation procedures. The average lesion diameter of 20mm (4 ~ 54mm). All treatment plans, procedures, and post-intervention monitoring were performed on a wide-bore 1.5TMR device. The success of the technique was assessed by an MR enhanced scan of the liver immediately after interventional treatment. The dynamic MR imaging of the liver was used to assess the effectiveness of ablation therapy one month later, with an average follow-up of 24.2 months (range, 5 to 44 months). Results 210/213 lesions (98.6%) achieved technical success and were technically effective. 18/210 lesions (8.6%) 4 to 28 months after treatment of tumor recurrence of local infiltration. Of the 18 lesions, seven achieved complete ablation, and the other six received surgical treatment. The overall RFR was 93.4% (199/213) and the overall treatment success (including surgery) was 96.2% (205/213). Two serious complications (1.3%) (bleeding and infectious bile tumor) and 14 (8.9%) minor complications occurred, of which 157 were affected by the intervention. Conclusion Radiofrequency ablation guided by wide caliber MR is a safe and effective treatment for liver diseases.