螺旋CT对原发性小肝癌射频消融术后的随访价值

Significance of helical CT in the postoperative follow-up evaluation in patients with primary HCC treated with radiofrequency ablation

目的探讨螺旋CT对原发性小肝癌射频消融术后的随访价值。方法选取2011年8月至2012年4月间上海中医药大学附属第七人民医院收治的行超声引导下经皮穿刺射频消融治疗的96例肝脏恶性肿瘤患者,包括69例原发性小肝癌和27例转移性小肝癌,定期进行螺旋CT双期增强扫描检查和MRI检查,观察射频消融的效果及肿瘤复发的情况。结果射频消融术后1个月螺旋CT复查,肿瘤完全坏死者64例(66.7%)肿瘤残留者18例(18.8%)。2例因故未作螺旋CT复查。射频消融术后3个月螺旋CT复查肝内肿瘤复发者12例(12.5%),其中6例为原位复发(6.3%)。与同期MRI检查结果比较,差异无统计学意义(P>0.05)。结论螺旋CT能对原发性小肝癌患者射频消融术治疗后的病灶变化进行监测和评价,在患者术后随访评价中具有重要的临床价值。

Objective To analyze the significance of helical CT in the postoperative follow-up evaluation in patients with primary small hepatocellular carcinoma（HCC） treated with radiofrequency ablation（RFA）.Methods Dual phase enhanced helical CT scans were regularly performed in 96 patients with liver malignant tumors undergoing ultrasound guided percutaneous RFA treatment at Seventh People＇s Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from August 2011 to April 2012 including 69 patients with primary small HCC and 27 patients with metastatic HCC.The efficacy of RFA and recurrence of tumors were observed.Results In the helical CT review at 1 month after RFA,complete tumor necrosis occurred in 64 patients（66.7%） and residual tumors occurred in 18 patients（18.8%）.Recurrence of the liver tumors occurred in 12 patients（12.5%） in the subsequent helical CT scan,among which 6 patients were in situ recurrence（6.3%）.Conclusion The same with MRI,helical CT is able to monitor and evaluate the changes of the lesions after RFA in patients with primary small HCC,and it has important clinical significance in the postoperative follow-up evaluation.