经皮肝穿射频消融治疗肝脏肿瘤术CT随访扫描技术探讨

CT Scanning in the Follow-up of the Patients with Hepatic Cancer Treated by Percutaneous Radiofrequency Ablation

目的评价超声引导经皮穿刺射频治疗肝癌术后CT随访的时机和扫描技术。方法回顾性分析198例超声引导经皮穿刺射频治疗肝癌术中的87例患者,在术后1周至6个月的CT扫描方法和CT表现。结果超声引导经皮穿刺射频治疗肝癌术后毁损灶在不同时期的CT表现各不相同。毁损灶在早期(一个月内)CT表现呈混合密度,中央区以稍高密度为主,而周围则呈低密度,病灶边界不清。增强扫描时中央区大部无强化,而边缘则呈不均匀强化。半年后随访病灶则呈边界清楚不强化的低密度影。结论早期CT随访判定局部是否存在出血,毁损灶大小,有着重要的作用。中后期强化扫描对病灶的残留和复发的诊断有着重要的意义。中后期CT随访时应常规进行螺旋双期扫描。

Objective To discuss the best time and scanning technique of CT follow-up for the patients with hepatic cancer treated by percutaneous radiofrequency ablation. Methods A retrospective analysis was given to 87 cases selected from 198 cases with hepatic cancer receiving percutaneous radiofrequency ablation guided by ultra-sound, their CT scanning methods and CT images from one week after operation to six months were studied. Resldts The CT images of the destroyed focus were different in different time after the operation; the CT images of the destroyed focus one month after operation showed mixed density, central higher and out-ring area lower, and showed nubilose edge of the focus; the enhencement scanning caused no obvious enhencement in the central area but a heterogeneous enheneement along the edge; the follow-up half year after operation showed a low density with clear edge of the focus. Conclusions The short-term CT follow-up after percutaneous radiofrequency ablation in the patients with hepatic cancer is of great importance to decide possible local hemorrhage and the focus size;the mid- and long-term CT follow-up with enheneement scanning is important for the diagnosis of the rudimentary focus and recurrence;double-phase scanning of spiral CT should be the routine in the mid- and long-term follow-up.