CT引导下乙醇消融术治疗肝转移瘤

CT-guided percutaneous ethanol injection for hepatic metastasis

目的探讨CT引导下无水乙醇消融术(PEI)在肝转移性肿瘤治疗中的价值。方法53例肝转移性肿瘤,共计87个病灶。18个病灶直径≤1 cm;56个病灶直径1～3 cm;13个病灶直径3～5 cm。采用ET引导下无水乙醇瘤内注射进行治疗,经过1次或多次治疗,观察肝转移瘤的坏死情况。结果PEI治疗后1个月MR或CT复查,18个直径≤1 cm的病灶完全坏死率为100%;直径1～3 cm 56个病灶完全坏死率为87．5%,再次治疗后完全坏死;13个病灶直径3～5 cm的病灶完全坏死率为61．5%,经过2～3次治疗,病灶彻底坏死。结论CT引导下无水乙醇消融术治疗肝转移性肿瘤疗效满意,尤其适用于直径≤3 cm的单个病灶。

Objective To evaluate the clinical value of CT-guided percutaneous pure ethanol injection （PEI） in hepatic metastasis. Methods Fifty three cases of metastatic tumor in liver with 87 lesions in total consisted of diameters of 18 lesions lesser than 1 cm, of 56 lesions ranging from 1 cm to 3 cm, and of 13 lesions more than 3 cm but less than 5 cm. These metastatic lesions were treated with CT-guided percutaneous pure ethanol injection and undergone necrosis after one or more PEI treatment. Results These metastatic 1 esions were reexamined by CT or MR one month post-treatment of PEI. Complete necrosis rate was 100% in 18 lesions with diameter less than 1 cm. Complete necrosis rate was 87.5% in 56 lesions ranging from 1 cm to 3 cm in diameter, the residual lesions were completely undergone necrosis after second ethanol injection. Complete necrosis rate of 61.5% for 13 lesions with diameter more than 3 cm but less than 5 cm obtained complete necrosis after two or three times with PEI. Conclusion Curative effect of CT-guided percutaneous pure ethanol injection in hepatic metastasis is satisfactory especially suitable for single lesion with diameter less than 3 cm.