3.0T MR引导下肝细胞癌射频消融术的可行性研究

Feasibility study of 3.0T MR-guided radiofrequency ablation for hepatocellular carcinoma

目的探讨3.0T MR引导下肝细胞癌(HCC) RFA治疗的可行性。方法收集22例肝癌患者27个病灶,在3.0T MR引导下进行RFA治疗。术后立即行MR扫描,以消融灶完全覆盖目标病灶并超出病灶边缘0.5~1.0 cm为完全消融;如存在残余病灶,则补充消融。治疗后1、3、6和12个月复查肝脏动态增强MRI,评价疗效。结果病灶平均最大径(17.6±5.3) mm(8~30 mm),技术成功率100%(27/27),疗效100%(27/27)。引导序列T1 Vibe fs 8~10 s,t2 haste fs 40~50 s。22例患者均配合良好,一次得到目标影像。消融灶在T2WI上呈等低信号,周围可见薄层高信号环绕;T1WI上呈特征性的"靶征"。术后无严重并发症。结论 3.0T MR引导下RFA治疗HCC成像速度快、图像敏感度高,疗效评价准确,是一种安全有效的治疗手段。

Objective To discuss the feasibility of 3.0 T MR-guided radiofrequency ablation(RFA) for the treatment of hepatocellular carcinoma(HCC). Methods A total of 22 HCC patients(27 lesions in total)were enrolled in this study. Under 3.0 T MR guidance, RFA was performed in all patients. MR scanning was performed immediately after RFA. It was defined as the complete ablation of HCC that when the ablated extent completely covered the target lesion and exceeded the lesion border 0.5-1.0 cm. Supplementary RFA treatment was carried out when residual lesion was detected. Dynamic contrast-enhanced MRI of liver was performed at one, 3, 6 and 12 months after RFA to evaluate the curative effect. Results The average maximum diameter of the lesion was(17.6±5.3) mm(range of 8-30 mm). The technical success rate was 100%(27/27) and the curative effect rate was 100%(27/27). Available guiding sequence was T1 Vibe fs 8-10 s, t2 haste fs 40-50 s. All the 22 patients cooperated well and the target images were obtained with one scanning.The ablated lesion presented as iso-low signal on T2 WI with thin-layer high-signal encirclement. After RFA,no serious complications occurred. Conclusion For the treatment of HCC, 3.0 T MR-guided RFA has certain advantages such as fast imaging speed, high image sensitivity and accurate evaluation of curative effect.Therefore, it is a safe and effective means of treatment for HCC.