摘要
目的探讨MRI引导下微波消融(MWA)治疗肺转移癌的技术可行性。方法回顾性分析2016年4月至2019年2月接受1.5T MRI引导下MWA治疗单发肺转移癌患者6例,其中原发性肝癌转移5例,直肠癌转移1例,病灶平均长径(1.83±0.95) cm(0.73~3.0 cm),在MRI引导下完成体表定位,穿刺、消融术中监控及天线调整,观察MWA术中和术后即刻MRI表现及并发症,随访复查判定消融疗效。结果 6例患者均顺利行1.5T MRI引导下肺转移癌MWA,平均手术时间(65.8±17.0) min(52~96 min),其中4例患者行MWA术中fsFRFSE T2WI动态扫描,表现为低信号的热凝固性坏死区范围随时间进展逐渐从中央向外周扩大并覆盖高信号原病灶区。术后即刻扫描示消融灶中央呈短T1短T2信号,周边见等T1长T2信号带环绕。术后1例患者出现中等量液气胸伴肺部感染。术后平均随访时间为(7.67±4.36)个月(2~13个月),随访复查示5个肺转移癌完全消融,1个肺转移癌近血管侧病灶4个月后出现局部肿瘤进展。结论 1.5T MRI引导下MWA治疗肺转移癌是一项可行的新技术。
Objective To investigate the technical feasibility of MRI-guided microwave ablation(MWA)in the treatment of lung metastases. Methods The clinical data of 6 patients with single lung metastasis, who received 1.5 T MRI-guided MWA during the period from April 2016 to February 2019, were retrospectively analyzed. The primary malignant lesions included hepatocellular carcinoma(n =5) and rectal cancer(n=1). The mean diameter of lesions was(1.83±0.95) cm(range of 0.73-3.0 cm). Under MRI guidance,the body surface positioning, puncture, ablation monitoring and antenna adjustment were accomplished. MRI findings and complications of during MWA and immediate after MWA were documented, follow-up reexamination was carried out to determine the curative effect of MWA. Results Successful 1.5 T MRI-guided MWA of lung metastasis was accomplished in all 6 patients. The mean time spent for MWA procedure was(65.8±17.0) min(range of 52-96 min). During MWA fsFRFSE T2 WI dynamic scan was performed in 4 patients, on MRI images the low-signal thermal coagulation necrosis area gradually expanded from the center to the peripheral area of the lesion over time and further covered the previous local high-signal lesion.Immediate postoperative MR scanning revealed that the center of the ablated zone presented as short T1 and short T2 signals surrounded by a ring-like iso-T1 and long-T2 signal zone. After MWA, one patient developed moderate hydropneumothorax associated with pulmonary infection. The average postoperative follow-up time was(7.67±4.36) months(2-13 months). Follow-up reexamination showed that 5 lung metastatic lesions achieved complete ablation and one lung metastatic lesion that was located close to blood vessel developed local tumor progression in 4 months after MWA. Conclusion For the treatment of lung metastases,1.5 T MRI-guided MWA is a clinically feasible and new technique.
作者
陈锦
林征宇
林清锋
严媛
林瑞祥
陈健
CHEN Jin;LIN Zhengyu;LIN Qingfeng;YAN Yuan;LIN Ruixiang;CHEN Jian(Department of Interventional Radiology,First Affiliated Hospital of Fujian Medical University,Fuzhou,Fujian Province 350000,China)
出处
《介入放射学杂志》
CSCD
北大核心
2019年第11期1056-1061,共6页
Journal of Interventional Radiology
关键词
磁共振成像
肺肿瘤
微波消融
magnetic resonance imaging
lung neoplasm
microwave ablation