CT矢状位重建在膈顶部肝肿瘤微波消融治疗中的应用

Application of computed tomography sagittal reconstruction for microwave ablation of hepatic carcinoma under the diaphragm

目的评估CT矢状位重建下经皮微波消融治疗膈顶部肝肿瘤的疗效。方法 8例原发性肝癌、2例肝转移瘤患者,共11枚肿瘤病灶,在CT矢状位重建下进行微波消融治疗,随访36个月,观察肿瘤清除率、局部复发率、生存率、远处转移及血清AFP变化。结果全组11枚肿瘤病灶完全清除率为90.9%;3例术前AFP≥200 ng/m L者中1例术后AFP<200 ng/m L(1/3);1、2、3年肿瘤局部复发率分别为20%、30%、30%;1、2、3年生存率分别为100%(10/10)、60%(6/10)、50%(5/10)。所有患者均未出现操作相关的严重并发症。结论 CT矢状位重建下微波消融治疗膈顶部肝肿瘤是无法治疗或拒绝外科手术切除肝肿瘤患者的有效治疗方法。

Objective To evaluate the efficacy of computed tomography（ CT） sagittal reconstruction for microwave ablation of hepatic tumor under the diaphragm. Methods A total of 8 patients with primary liver cancer and 2 patients with hepatic metastases（ altogether 11 lesions） who underwent microwave ablation with CT sagittal reconstruction were involved. During the follow-up of 36 months,the tumor clearance rate,local recurrence rate,survival rate,distant metastasis and changes of alpha fetal protein（ AFP） were observed. Results The overall clearance rate was 90. 9%. Of the 3 patients with preoperative AFP ≥ 200 ng/m L,1 patient had AFP reduced to 〈 200 ng/m L. The 1-,2-and 3-year local recurrence rate was 20%,30% and 30%. The 1-,2-and 3-year overall survival（ OS） was 100%,60% and50%. No serious operation-related complications were observed. Conclusion Microwave ablation of hepatic carcinoma under the diaphragm with CT sagittal reconstruction is a preferred method if patients are unresectable.