3.0T大孔径MR引导下肝癌微波精确消融毁损治疗

3.0T MR Guided Precise Microwave Ablation for Hepatocellular Carcinoma

目的观察3.0 T大孔径MR引导下精确微波消融毁损局部复发/残留肝癌的临床疗效。方法2019年1月至6月间,22例肝癌术后复发/残留患者(介入栓塞术后10例,外科术后7例,消融术后5例)于郑州大学第一附属医院介入科接受3.0 T大孔径MR引导下精确微波消融毁损术。记录手术时间、技术成功率、完全消融率、并发症、局部进展率和总生存时间,比较术前及术后2个月甲胎蛋白和生化指标。结果平均手术时间49.6 min,技术成功率和完全消融率均为100%,仅1例患者并发胸腔积液,无大出血、感染、胆瘘、肝衰等并发症发生。平均随访12.5个月,无局部进展,死亡1例。术后2个月甲胎蛋白较术前明显下降(t=6.09,P<0.01),血常规、肝肾功能无明显变化(P>0.05)。结论3.0 T大孔径MR引导下肝癌微波消融术可实现对局部复发/残留病灶精准毁损。

Objective To observe the clinical efficacy of 3.0 T closed MR guided precise microwave ablation for locally recurrent/residual liver cancer.Methods From January to June 2019,22 patients with recurrent or residual liver cancers(10 cases after interventional embolization,7 cases after surgery,and 5 cases after ablation)underwent precise microwave ablation guided by 3.0 T closed MR in Department of International Radiology,The First Affiliated Hospital of Zhengzhou University.The operation time,technical success rate,complete ablation rate,complications,local progression and overall survival time were recorded.Alpha feto protein and biochemical indexes were compared before and 2 months after operation.Results The average operation time was 49.6 min.the technical success rate and complete ablation rate were 100%,respectively.The main complications were 4.5%(1/22).There were no complications such as massive hemorrhage,infection,biliary fistula and liver failure.The local progression rate was 0%.One patient died and the others survived,and the average overall survival was 12.5 months.Alpha fetoprotein decreased significantly 2 months before and 2 months after operation[(137.7±95.3)vs(18.7±10.1)t=6.09,P<0.01],blood routine test and liver and kidney function showed no change significantly(P>0.05).Conclusion 3.0 T closed MR guided precise microwave ablation can be preferable choice for locally recurrent/residual liver cancer.