CT引导下经皮靶向冷冻治疗肺肿瘤的效果及其CT表现

Therapeutic efficacy and imaging findings of CT guided percutaneous targeted cryoablation for pulmonary malignant tumors

目的评价冷冻消融治疗肺肿瘤的效果,并分析其治疗前后CT表现的动态变化。方法43例经病理证实的肺恶性肿瘤(35例肺癌和8例肺转移瘤)患者均接受CT引导下经皮靶向冷冻治疗。依据术中肿瘤病变的CT表现,将所有患者分为完全消融和部分消融两组,其疗效于手术当时和术后1,3,6个月以CT平扫和增强扫描进行了随访。结果在完全消融的29例中,其病变区肿瘤消融完全,随访CT像上无增强表现,消融区病变随时间延长逐渐减少或消失。在部分消融的14例中,其消融区病变呈现各种不同增强形态,病变大小随时间延长而增减。结论CT引导下经皮靶向消融治疗肺恶性肿瘤安全且有效。术中消融区是否完全覆盖病变区的CT表现,消融区病变是否强化,以及强化形态与时间,是判断冷冻消融疗效的重要依据。

Objective To assess the efficacy of cryoablation for treating pulmonary tumors and analyze the dynamic changes in CT findings before and after the treatment. Metbods Forty-thee patients with pathologically proved pulmonary malignant tumors （35 of lung cancer and 8 of lung metastases）underwent CT guided pereutaneous targeted cryoablation. All patients were divided into two groups of complete ablation and partial ablation according to intraoperative CT findings. The efficacy of cryoablation was followed-up by witholut and with contrast enhanced CT scans in a moment of operation and at 1, 3 and 6 months after the treatment. Results In 29 patients with complete ablation, tumors in lesion region were complete ablation without enhanced signs on followed -up CT images, while the lesions in ablation region were gradually reduced or disappeared with time prolongation. In 14 patients with partial ablation, the lesions in ablation region showed varied enhanced shapes while the lesions in size were enlarged or reclueed with time prolongation. Conclusion CT guided percutaneous targeted eryoablation is safe and effective for treating pulmonary malignant tumors. CT findings which whether intraoperative ablation region can completely envelop the lesion region, whether the lesion in ablation region is enhanced, enhanced shape and duration of the lesion in ablation region are important evidences to identify the efficacy of eryoablation.