周围型肺癌微波消融术后半年CT随访变化

Six Month Follow up CT Findings of Microwave Ablation Response in Bronchogenic Carcinoma

目的探讨周围型肺癌微波消融术后半年内CT增强随访的恰当次数。方法对24例周围型肺癌微波消融术后患者,采用64层螺旋CT在术后1个月、3个月及6个月行CT增强双期扫描(以3 ml/s的流率注入对比剂),分别在25 s及120 s行胸部扫描。记录病灶治疗前、治疗后、治疗后强化区最大单径之和、治疗后未强化区最大单径之和及治疗后空洞最大内径之和。使用均数间方差检验、配对t检验进行统计学分析。结果病灶最大单径之和在治疗后1个月(3.67±1.16)cm、3个月(3.00±1.00)cm及6个月(2.87±1.13)cm与治疗前病灶最大单径之和(3.42±1.31)cm相比,无显著差异(f=1.025,P=0.391,>0.05)。治疗后1个月(0.53±0.53)cm、3个月(0.52±0.55)cm及6个月(0.67±0.81)cm之间,病灶强化区最大单径之和无显著差异(f=0.174,P=0.841,>0.05)。治疗后1个月(3.42±1.12)cm、3个月(3.00±0.89)cm及6个月(2.64±0.99)cm之间,病灶未强化区最大单径之和无显著差异(f=1.845,P=0.174,>0.05)。治疗后1个月(1.74±1.44)cm、3个月(1.26±1.29)cm及6个月(1.17±1.08)cm之间,病灶空洞最大内径之和无显著差异(f=0.695,P=0.506>0.05)。治疗后1个月、3个月及6个月病灶强化区最大单径之和明显小于治疗前病灶最大单径之和(f=16.765,P<0.001)。结论周围型肺癌微波消融治疗后病灶大部分发生了坏死,术后半年内CT增强随访未见明显变化,建议术后半年进行一次CT随访。

Objective To determine an optimal times of contrast material enhanced computed tomography （CT） examination in peripheral bronehogenic carcinoma after microwave ablation during six month follow up preliminarily, by analyzing numerous CT findings. Methods 24 Patients with peripheral bronehogenic carcinoma after microwave ablation underwent two phases contrast material enhanced computed tomography （CT） after microwave ablation one month, three month, and six month respectively. Two spiral CT scans were obtained at 25 and 120 seconds respectively after nonionic contrast material was administrated via the antecubital vein at a rate of 3mL/sec by using an autoinjeetor. The sum of the tumor longest diametem （LD） prior to treatment, after treatment, the sum of the post treatment tumor enhancement area LD, the sum of the post treatment tumor no enhancement area LD and the sum of the post treatment tumor cavity area LD were recorded. The significance of the difference among goups was analyzed by means of ANOVA, student t test. Results There were no statistically significant differences among the sum of＇ the tumor longest diameters （LD） after microwave ablation one month （ 3.67 ± 1.16 ） cm, three month （ 3.00 ± 1.00 ）em and six month （ 2.87 ± 1.13 ） cm, and prior to treatment （ 3.42 ± 1.31 ） cm （f= 1. 025, P = 0.391 〉 0.05 ）. No statistically significant difference in the sum of the post treatment tumor enhancement area LD were found among after microwave ablation one month （0.53 ± 0.53 ）era, three month （0.52± 0.55 ）cm and six month（0.67±0.81 ）cm（f=0. 174, P =0. 841 〉0.05）. There were no statistically significant differences among the sum of the post treatment tumor; no enhancement area LD after microwave ablation one month（3.42 ± 1.12）cm, three month （ 3.00 ± 0.89 ） cm and six month （ 2.64 ± 0.99 ） cm （f = 1. 845, P = 0.174 〉 0.05 ）. No statistically significant difference in the sum of the post treatment tumor cavity area LD were found among after microwave ablation one month（ 1.74 ± 1.44 ） cm, three month （ 1.26± 1.29） cm and six month （ 1.17 ± 1.08 ） cm （f = 0. 695, P = 0. 506 〉 0.05 ）. The sum of the post treatment tumor enhancement area LD after microwave ablation one month, three month and six month were significantly low- er than the sum of the tumor longest diameters （LD） prior to treatment （f = 16. 765,P 〈 0. 001 ）. Conclusion Majority of bronchogenic carcinoma after microwave ablation shows necrotic lesion. No significant changes in contrast material enhanced CT findings of microwave ablation response in peripheral bronchogenic carcinoma are founded during six month follow up. One contrast material enhanced CT is recommended during six month for follow up.