超声引导多点扇形立体定位单极冷循环射频消融治疗肝癌

Ultrasound-guided multiple-spot sector stereotaxis in unipolar cooling cycle radiofrequency ablation of hepatic carcinomas

目的评价超声引导多点扇形立体定位单极冷循环射频消融治疗肝癌的效果。方法对96例肝癌患者的112个肿瘤,采用多点扇形立体定位法施行超声引导经皮射频消融(RFA)治疗。治疗后15 min行超声造影(CEUS),判断肿瘤是否完全灭活,如灭活不完全则进行重复治疗,治疗后1个月行增强CT(CECT)或CEUS检查评估治疗效果。结果112个肿瘤共穿刺293次,成功穿刺269次,穿刺成功率91.81%。治疗后15 min,CEUS示肿瘤无增强。治疗后1个月CT复查,肿瘤体积缩小;89.29%肿瘤CECT无强化,10.71%存在部分强化;CEUS示87.38%肿瘤内无增强,12.62%存在部分增强。结论超声引导多点扇形立体定位单极冷循环RFA治疗肝癌疗效可靠,可提高消融治疗对较大肝癌的灭活率。

Objective To assess the effect of ultrasound-guided multiple-spot sector stereotaxis in unipolar cooling cycle radiofrequency ablation of hepatic carcinomas.Methods Ninety-six patients with 112 liver malignancies were treated with ultrasound-guided percutaneous radiofrequency ablation using multiple-spot sector stereotaxis method.Conventional multi-section ultrasound scanning was performed to determine the exact location of tumors.Contrast enhanced ultrasound（CEUS） was performed 15 minutes after treatment to determine whether the tumors were completely inactivated.Contrast enhanced CT（CECT） and CEUS were performed 1 month after treatment to evaluate the therapeutic effect.Results A total of 293 punctures were performed for 112 tumors,technical successful rate with a successful rate of puncture was 91.81%（269/293）.CEUS showed no blood flow signals in the tumors 15 minutes after therapy.One month after therapy,CT showed the volume of tumors shrunk,no enhancement was found in 100 tumors（100/112,89.29%）,while partial reinforcement was noticed in 12 tumors（10.71%）.Meanwhile,CEUS showed no enhancement in 90 tumors（90/103,87.38%）,when partial reinforcement was noticed in 13 tumors（13/103,12.62%）.Conclusion Ultrasound-guided multiple-spot sector stereotaxis unipolar cooling cycle radiofrequency ablation is an effective and reliable method to treat hepatic carcinomas.