MRI引导肺癌射频消融治疗的临床应用

Clinical application of MRI-guided radiofrequency ablation for lung cancer

目的探讨MRI在肺癌射频消融(RFA)治疗过程中定位及引导的安全性和可行性。方法26例患者应用MRI引导进行肺癌病灶定位并完成RFA治疗,观察定位的准确性及成功率,分析治疗对生存期的影响,同时观察MRI引导RFA治疗的不良反应发生率等安全性指标,进一步评价MRI在引导RFA治疗中的价值及可行性。结果26例肺癌患者全部定位成功,13例出现并发症,其中气胸8例、胸水8例,合并肺炎、皮下组织积气及术中咳血各1例。所有病灶1~4年局部控制率分别为87.2%、69.9%、48.1%、24.8%;1~5年生存率分别为86.5%、66.2%、66.2%、66.2%、22.1%。结论MRI引导肺癌RFA定位准确、操作安全、无辐射损伤,大部分患者的局部肿瘤控制效果较好,生存期延长,是一种临床操作安全可靠的局部肺肿瘤治疗方法。

Objective To investigate the application value of MRI in localization and guidance during radiofrequency ablation of lung cancer and observe the clinical safety and feasibility of MRI-guided ablation.Methods Twenty-six patients were guided by MRI to locate lung cancer lesions and complete radiofrequency ablation,to observe the accuracy and success rate of localization,and to analyze the effect of treatment on survival time.The clinical value and feasibility of MRI-guided radiofrequency ablation were further evaluated.Results All 26 lung cancer patients were successfully located.Thirteen complications(50.00%)occurred in 26 cases,including 8 cases of pneumothorax(30.77%),8 cases of pleural effusion(30.77%),1 case of pneumonia、subcutaneous pneumatosis and intraoperative hemoptysis respectively(3.85%each).Local control rates were 87.20%、69.93%、48.14%and 24.77%in 1-4 years respectively;The survival rats were 86.5%、66.19%、66.19%、66.19%and 22.06%1-5 years respectively.Conclusion MRI-guided radiofrequency ablation of lung cancer is a minimally invasive treatment with accurate location,safe operation and no radiation injury.Most patients can obtain better local control and prolong the survival time.It is a safe and reliable local treatment method of lung cancers in clinical practice.