病灶面积最大投影法用于CT引导下经皮肝肿瘤微波消融术

Maximum projection method of lesion area in CT-guided percutaneous microwave ablation of liver tumor

目的探讨病灶面积最大投影法在CT引导下经皮肝肿瘤微波消融术中的应用价值。方法对23例肝肿瘤患者行CT引导下经皮肝肿瘤微波消融治疗,其中15例(研究组)在术中采用病灶面积最大投影法指导消融针穿刺并预测消融范围,8例(对照组)行常规CT引导下经皮微波消融。比较2组术中穿刺次数、术后并发症情况及近期疗效。结果研究组术中穿刺次数少于对照组[(1.27±0.46)次vs (3.62±0.74)次;t=-9.461,P<0.001]。2组患者术后并发症仅为肝包膜下出血,且研究组发生率低于对照组[6.67%(1/15) vs 37.50%(3/8);χ~2=3.976,P=0.041]。研究组术后6个月内肝肿瘤完全消融率明显高于对照组[93.33%(14/15) vs 50.00%(4/8);χ~2=5.647,P=0.017]。结论 CT引导下经皮肝肿瘤微波消融术中采用病灶面积最大投影法指导消融针穿刺并预测消融范围,有利于提高肿瘤完全消融率,同时减少并发症。

Objective To explore the application value of maximum projection method of lesion area in CT-guided percutaneous microwave ablation of liver tumor.Methods CT-guided percutaneous microwave ablation was performed on23 patients with liver tumor.All patients were divided into two groups.Fifteen patients underwent CT-guided percutaneous microwave ablation with maximum projection method of lesion area in study group,wihle 8 patients underwent CT-guided percutaneous microwave ablation with conventional method in control group.The times of puncture during operation,complications and the short-term efficacy of microwave ablation were compared between the two groups.Results Compared with control group,the times of puncture during operation decreased in study group([1.27±0.46]times vs[3.62±0.74]times;t=-9.461,P<0.001).No complication occurred after ablation except for subcapsular hemorrhage in both of the two groups,and the incidence of subcapsular hemorrhage in study group was lower than that in control group(6.67%[1/15]vs 37.50%[3/8];χ~2=3.976,P=0.041).Furthermore,the complete ablation rate of liver tumor in study group was higher than that in control group within 6 months after operation(93.33%[14/15]vs 50.00%[4/8];χ~2=5.647,P=0.017).Conclusion Maximum projection method of lesion area can be used to guide puncture and predict the ablation range during CT-guided percutaneous microwave ablation of liver tumors,which is helpful for the improvement of complete ablation rate and reducing complications.