肝脏恶性肿瘤的射频消融治疗

Radiofrequency ablation for malignant liver tumors

射频消融不仅可治疗小肝癌,还可通过联合肝动脉化疗栓塞等技术用于大肝癌的治疗,其适应证广泛。常用的射频系统包括单极电极射频系统和双极/多极电极射频系统。射频消融可单独使用,也可与手术切除、经导管动脉栓塞、经皮穿刺注射无水乙醇等技术联合,与其他局部消融方法相比更安全可靠。操作可在术中超声引导下进行,也可在腹腔镜下或影像导引下经皮穿刺进行。影像引导操作安全可靠,术后并发症少,是主要的操作方式。超声造影、增强CT、增强MRI以及正电子发射体层成像均为理想的术后疗效评价手段。

The indications of radiofrequency ablation （RFA） for liver malignancies have been broaden.The technique has been applied not only in the treatment of small hepatocellular carcinoma （HCC）,by combining with transcatheter arterial chemoembolization （TACE）,it has also been used in the treatment of large tumors.Radiofrequency generator and electric probe are generally classified into the monopolar and the bipolar/multipolar systems.RFA could be used alone or combined with surgical resection,TACE,or percutanous ethanol injection （PEI） and other techniques.Compared with other local ablative modalities,RFA is more effective and safer.RFA can be performed safely using percutaneous,laparoscopic,or open surgical techniques.Image guided RFA is the main trend and is safe and reliable with acceptable morbidity.Contrast-enhanced ultrasonography,enhanced CT scan,contrasted MRI,and PET are all the reliable modalities for evaluating RFA curative effect.