Treatment of hepatic cysts by B-ultrasound-guided radiofrequency ablation

BACKGROUND: The traditional therapy for hepatic cysts has limited success because of recrudescence. Radiofrequency ablation (RFA) has become popular because of its advantages including little damage, therapeutic effect and reduced suffering. This report describes the effects and reliability of RFA in the treatment of 29 patients with hepatic cysts. METHODS: B-ultrasound-guided REA was used to treat hepatic mono-cyst or multi-cysts of 29 patients (63 tumors). Ablative efficiency and complications were assessed by imaging and clinical symptoms. RESULTS: The tumors were abated completely in 34 cysts with a diameter <5 cm and no recurrence was seen after 3 months. In 21 cysts with a diameter of 5-10 cm, tumor volume was decreased by over 70%, then reduction and fiberosis were found. In 8 cysts with a diameter greater than 10 cm, tumor volume was decreased by more than 60%, and in 2 cysts it was increased more slightly than that at I month after REA. In subsequent follow-up (6 and 12 months after REA), tumors <10 cm in diameter were fully ablated. No significant discomfort and complications were found in any patient. CONCLUSION: RFA for the treatment of hepatic cysts is safe, and free from complications.

Correlation between CT dynamic enhanced scanning parameters and serum tumor markers before and after radiofrequency ablation in patients with lung cancer

Objective:To study the correlation between CT dynamic enhanced scanning parameters and serum tumor markers before and after radiofrequency ablation in patients with lung cancer.Methods:60 patients with advanced non-small cell lung cancer who were treated in this hospital between January 2015 and January 2017 were divided into control group(n=30)and observation group(n=30)by random number table method.Control group received conventional intravenous chemotherapy,and observation group received intravenous chemotherapy combined with radiofrequency ablation.The differences in CT dynamic enhanced scanning parameter levels and serum tumor marker contents were compared between the two groups of patients before and after treatment.Pearson test was used to evaluate the correlation between CT dynamic enhanced scanning parameters and serum tumor marker contents in patients with advanced non-small cell lung cancer.Results:Before treatment,the differences in CT dynamic enhanced scanning parameter levels,non-organ-specific tumor marker contents and vascular tumor marker contents were not statistically significant between the two groups of patients(P>0.05).After treatment,CT dynamic enhanced scanning parameters PH and perfusion value levels of observation group were lower than those of control group(P<0.05);serum non-organ specific tumor markers CA125,CA153,CEA and CYFRA21-1 contents of observation group were lower than those of control group;serum vascular tumor markers VEGF,Ang-2,HIF-1 and MMP-9 contents were lower than those of control group(P<0.05).Pearson test showed that CT dynamic enhanced scanning parameters PH and perfusion value levels in patients with non-small cell lung cancer were positively correlated with serum non-organ specific tumor marker and vascular tumor marker contents.Conclusion:Adjuvant radiofrequency ablation can significantly reduce the tumor malignancy of patients with advanced non-small cell lung cancer.

Changes of CT dynamic contrast-enhanced scan parameters in patients with lung cancer before and after radiofrequency ablation

Objective:To study the changes of CT dynamic contrast-enhanced scan parameters in patients with lung cancer before and after radiofrequency ablation (RFA) and their correlation with serum tumor markers.Methods:A total of 60 patients who were diagnosed with lung adenocarcinoma in the Second Hospital of Yulin City between May 2015 and January 2017 were selected and randomly divided into the RFA group and control group who received RFA combined with GP chemotherapy and GP chemotherapy alone respectively. Before and after treatment, CT dynamic contrast-enhanced scan was performed to calculate blood perfusion parameters, and serum was collected to determine the contents of cancer cell proliferation activity molecules, angiogenesis molecules and cell invasion molecules.Results: After treatment, BF, BV, MTT and PS levels as well as serum CYFRA21-1, SCC-Ag, TK-1, HE-4, TPS, HDGF, VEGF, PCDGF, bFGF, NGAL, MMP7, MMP9 and OPN contents of both groups of patients were significantly lower than those before treatment, and BF, BV, MTT and PS levels as well as serum CYFRA21-1, SCC-Ag, TK-1, HE-4, TPS, HDGF, VEGF, PCDGF, bFGF, NGAL, MMP7, MMP9 and OPN contents of RFA group after treatment were significantly lower than those of control group.Conclusions:The changes of CT dynamic contrast-enhanced scan parameters in patients with lung cancer before and after radiofrequency ablation suggest that the blood perfusion significantly reduces and is closely related to cancer cell proliferation and invasion as well as angiogenesis.

Ten-year survival of hepatocellular carcinoma patients undergoing radiofrequency ablation as a first-line treatment

AIM: To investigate the long-term survival and prognostic factors in hepatocellular carcinoma (HCC) patients undergoing radiofrequency ablation (RFA) as a first-line treatment.METHODS: From 2000 to 2013, 316 consecutive patients with 404 HCC (1.0-5.0 cm; mean: 3.2 &#x000b1; 1.1 cm) underwent ultrasonography-guided percutaneous RFA as a first-line treatment. There were 250 males and 66 females with an average age of 60.1 &#x000b1; 10.8 years (24-87 years). Patients were followed for 1 year to &#x0003e; 10 years after RFA (234, 181, 136, and 71 for 3, 5, 7, and 10 years, respectively). Overall local response rates and long-term survival rates were assessed. Survival results were generated using Kaplan-Meier estimates, and multivariate analysis was performed using the Cox regression model.RESULTS: In total, 548 RFA sessions were performed and major complications occurred in 10 sessions (1.8%). Local tumor progression and/or new tumor development were observed in 43.3% (132/305) of the patients during the follow-up period. Overall 5- and 10-year survival rates were 49.7% and 28.4%, respectively. Based on multivariate analysis, three factors were identified as independent prognostic factors for overall survival: Child-Pugh classification (HR = 4.054, P &#x0003c; 0.001), portal vein hypertension (HR = 2.743, P = 0.002), and tumor number (HR = 2.693, P = 0.003). The local progression-free 5- and 10-year survival rates were 42.7% and 19.5%. In addition to the Child-Pugh classification and the number of tumors, the number of RFA sessions (HR = 1.550, P = 0.002) was associated with local progression-free survival.CONCLUSION: RFA can achieve acceptable outcomes for HCC patients as a first-line treatment, especially for patients with Child-Pugh class A, patients with a single tumor and patients without portal vein hypertension.

Current status of radiofrequency ablation of hepatocellular carcinoma

Loco-regional treatments for hepatocellular carcinoma(HCC) are important alternatives to curative transplantation or resection.Among them,radiofrequency ablation(RFA) is accepted as the most popular technique showing excellent local tumor control and acceptable morbidity.The current role of RFA is well documented in the evidence-based practice guidelines of European Association of Study of Liver,American Association of Study of the Liver Disease and Japanese academic societies.Several randomized controlled trials have confirmed that RFA is superior to percutaneous ethanol injections in terms of local tumor control and survival.The overall survival after RFA is comparable to after surgical resection in a selected group of patients with smaller(< 3 cm) tumors.Currently,the clinical benefits of combined RFA with transarterial chemoembolization for intermediate stage HCC are increasingly being explored.Here we review the ongoing technical advancements of RFA and future potential.

A modified radiofrequency ablation approach for treating distant lymph node metastasis in two patients with late-stage cancer

Patients with late-stage cancer commonly have distant lymph node metastasis;however,poor health often contraindicates surgical treatment.Although the quality of life and overall survival for these patients are low,there is neither a consensus nor a guide for treatment.Ablation technique and surrounding tissue damage are two possible reasons for limited study of radiofrequency ablation in patients with superficial distant lymph node metastasis.Here,we report two patients treated successfully with ultrasound-guided radiofrequency ablation for superficial distant lymph node metastasis.In these patients,deionized water was injected to the surrounding tissues of the lymph node to decrease heat injury.Results from these patients suggest that radiofrequency ablation may play an important role in the treatment of patients with distant lymph node metastasis.

The clinical efficacy analysis of radiofrequency ablation combined with chemotherapy in treating late non-small cell lung cancer

Objective:To study the short-term efficacy and improvement effect on the quality of life of CT guided radiofrequency ablation(RFA)in treating late non-small cell lung cancer.Methods:317 patients with non-small cell lung cancer(87 cases in the observation group and 230 cases in the control group)were selected for propensity score matching,with a matching tolerance of 0.05,and 42 pairs were successfully paired.The changes in chest enhanced CT before and 3 months after treatment and the quality of life measurement scale EORTC QLQ-C30 in Chinese version were evaluated.Results:The disease control rate of the observation group was 88.09%,which was significantly higher than that of the control group(61.91%).The functional and symptom scores of the two groups after treatment were significantly better than those before treatment,and the indicators of the observation group after treatment were better than those of the control group(P<0.05).Conclusion:CT-guided radiofrequency ablation combined with chemotherapy is safe and effective in the treatment of NSCLC,which can control local tumor progression,reduce tumor burden,and improve the quality of life of patients with advanced NSCLC.

CT引导微波消融结合载药栓塞微球经肝动脉化疗栓塞治疗原发性肝癌的临床疗效

目的:研究CT引导微波消融(CT-MWA)结合载药栓塞微球经肝动脉化疗栓塞(DEB-TACE)治疗原发性肝癌的临床疗效及影响术后无瘤生存时间的危险因素。方法:选取80例原发性肝癌患者作为研究对象,按照治疗方式不同将患者分为研究组和对照组,每组各40例。对照组采用DEB-TACE治疗;研究组采用CT-MWA结合DEB-TACE治疗,比较两组患者疗效、肝功能指标及不良反应发生情况,并分析其影响因素。结果:治疗后,研究组患者总有效率高于对照组(P<0.05);治疗后两周内,两组谷丙转氨酶(ALT)、天门冬氨基酸转移酶(AST)、总胆红素(TBIL)水平均降低,且研究组低于对照组(P<0.05),血清白蛋白(ALB)水平均升高,且研究组高于对照组(P<0.05);研究组不良反应发生率低于对照组(P<0.05)。单因素分析结果显示,肿瘤多发、肿瘤大小>3 cm及甲胎蛋白>20μg/L的患者平均无瘤生存时间更短(P<0.05);有肝病病史、肿瘤数量多发、肿瘤大小>3 cm及单纯采用DEB-TACE术式的患者平均总生存时间更短(P<0.05);多因素分析结果显示,Child-Pugh分级B级、肿瘤数量多发、肿瘤大小>3 cm及甲胎蛋白>20μg/L、单纯采用DEB-TACE手术方式的患者平均无瘤生存时间更短(P<0.05);有肝病病史、肿瘤数量多发、肿瘤大小>5 cm及单纯采用DEB-TACE手术方式的患者平均总生存时间更短(P<0.05)。结论:CT-MWA结合DEB-TACE治疗原发性肝癌手术效果良好,安全性较高,Child-Pugh分级﹑甲胎蛋白>20 pg/L、肿瘤直径>5 cm及肿瘤多发等均是影响患者生存期的独立危险因素。

CT引导下经皮肺穿刺活检后继发空气栓塞1例并文献复习

目的探讨CT引导下肺穿刺活检及消融后继发空气栓塞患者的临床特点、诊断及鉴别诊断要点、治疗策略,提高对该并发症的认识。方法回顾性分析河南省直第三人民医院2023年1月28日收治的1例的肺穿刺活检及消融后继发空气栓塞患者的临床资料,并进行相关文献复习。结果患者为52岁女性,因间断胸闷、气短1个月,加重1 d入院。入院CT增强扫描提示:右肺上叶新发磨玻璃结节,不排除恶性可能,经影像科及放射介入科讨论后行CT引导下肺穿刺活检+射频消融术,术中发现大量空气栓塞,经抢救后患者脱离生命危险,1 h后返回病房。结论CT引导下肺穿刺活检及消融是临床上较为常规技术,但术前需要对相关风险因素进行评估并制定应急管理策略,将患者发生并发症发生概率降至最低。一旦出现空气栓塞等严重并发症,需要术者及时准确识别、紧急复苏,以减少患者后遗症,降低病死率。

Accuracy of combined PET/CT in image-guided interventions of liver lesions: An ex-vivo study

AIM： Positioning of interventional devices in liver lesions is a challenging task if only CT is available. We investigated the potential benefit of combined PET/CT images for localization of interventional devices in interventional liver studies. METHODS： Thirty lesions each of hyperdense, isodense and hypodense attenuation compared to normal liver parenchyma were injected into 15 ex-vivo pig livers. All lesions were composed of the same amounts of gelatine containing 0.5 MBq of ^18F-FDG. Following lesion insertion, an interventional needle was placed in each lesion under CT-guidance solely. After that, a PET/CT study was performed. The localization of the needle within the lesion was assessed for CT alone and PET/CT and the root mean square （RMS） was calculated. Results were compared with macroscopic measurements after lesion dissection serving as the standard of reference. RESULTS： In hypo- and isodense lesions PET/CT proved more accurate in defining the position of the interventional device when compared with CT alone. The mean RMS for CT and PET/CT differed significantly in isodense and hypodense lesions. No significant difference was found for hyperdense lesions. CONCLUSION： Combined FDG-PET/CT imaging provides more accurate information than CT alone concerning the needle position in FDG-PET positive liver lesions. Therefore combined PET/CT might be potentially beneficial not only for localization of an interventional device, but may also be beneficial for guidance in interventional liver procedures.

CT引导下微创三氧消融术联合塞来昔布治疗腰椎间盘突出症的临床价值

目的:分析CT引导下微创三氧消融术联合塞来昔布治疗腰椎间盘突出症的临床价值。方法:选取2022年1月—2023年1月厦门市第五医院收治的60例腰椎间盘突出症患者作为研究对象,根据治疗方法不同分为治疗组、对照组,各30例。治疗组采用CT引导下微创三氧消融术联合塞来昔布治疗,对照组采用CT引导下微创三氧消融术治疗。比较两组治疗前后疼痛程度、腰椎功能、实验室指标及不良反应发生率。结果:治疗30 d、3个月、6个月后,治疗组视觉模拟评分法(VAS)评分低于对照组,差异有统计学意义(P<0.05)。治疗6个月后,治疗组改良日本骨科协会腰痛评分表(M-JOA)评分、腰椎功能障碍指数(ODI)评分、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、5-羟色胺(5-HT)、环氧化酶-2(COX-2)、血管内皮生长因子(VEGF)水平均低于对照组,基质金属蛋白酶-9(MMP-9)、磷酸化-P38丝裂原活化蛋白激酶(p-P38MAPK)水平高于对照组,差异有统计学意义(P<0.05)。治疗6个月后,治疗组腰椎疼痛、下肢麻木、活动受限评分低于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:CT引导下微创三氧消融术联合塞来昔布治疗腰椎间盘突出症可减轻患者疼痛,改善症状,提高腰椎功能,有利于降低炎症因子和疼痛介质水平,有利于p-P38MAPK通路蛋白的表达,并且治疗安全性较高。

CT联合常规超声引导微波消融术治疗肝血管瘤患者的效果

目的:观察CT联合常规超声引导微波消融术治疗肝血管瘤患者的效果。方法:选取2021年7月至2023年7月该院收治的80例肝血管瘤患者进行前瞻性研究,按照随机数字表法将其分为观察组和对照组各40例。对照组采用常规超声引导微波消融术治疗,观察组在对照组基础上联合CT检查,比较两组消融指标水平、治疗前后肝功能指标[丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TBIL)]水平、术后1个月并发症发生率和术后随访6个月的复发率。结果:观察组消融能量低于对照组,消融时间短于对照组,消融点数少于对照组,完全消融率高于对照组,差异均有统计学意义(P<0.05);术后7 d,两组ALT、AST和TBIL水平均低于术前,但组间比较,差异无统计学意义(P>0.05);两组并发症发生率比较,差异无统计学意义(P>0.05);术后随访6个月,两组均无复发。结论:CT联合常规超声引导微波消融术治疗肝血管瘤患者可改善消融指标水平,效果优于单纯常规超声引导微波消融术治疗。

CT引导下射频热凝治疗原发性三叉神经痛的效果分析

目的:分析CT引导下射频热凝治疗原发性三叉神经痛的效果。方法:研究对象为2019年6月—2023年6月徐州市贾汪区人民医院收治的80例原发性三叉神经痛患者,随机分为对照组及观察组,各40例。对照组实施星状神经节阻滞,观察组实施CT引导下射频热凝。比较两组疼痛情况、治疗效果、并发症发生情况、生活干扰。结果:治疗后3、6个月后,两组疼痛评分比治疗前低,且观察组比对照组低(P<0.05)。观察组治疗总有效率高于对照组,并发症总发生率低于对照组(P<0.05)。治疗后6个月后,两组食欲、睡眠、精神状态、情绪、生活情趣、与人交往评分低于治疗前,且观察组低于对照组(P<0.05)。结论:CT引导下射频热凝治疗原发性三叉神经痛的效果显著,可减轻患者疼痛,降低并发症发生率,改善对生活的干扰。

CT引导下射频热凝腰交感神经节治疗Ⅱ型复杂性区域疼痛综合征的临床效果

目的探究CT引导下射频热凝腰交感神经节治疗Ⅱ型复杂性区域疼痛综合征的临床效果。方法方便选取金湖县人民医院于2020年6月—2023年6月接收的68例Ⅱ型复杂性区域疼痛综合征患者为研究对象。利用红蓝球法将患者分为对照组和观察组,各34例。对照组予以超声引导下腰交感神经阻滞治疗,观察组予以CT引导下腰交感神经节射频热凝治疗。对比两组治疗后血液流变学指标、疼痛程度、并发症情况及有效率。结果对照组各项血液流变学指标水平均高于观察组,差异有统计学意义(P均<0.05);观察组治疗后第3、7、14天疼痛评估量表(Numeric Rating Scale,NRS)评分均低于对照组,差异有统计学意义(P均<0.05);观察组治疗后并发症总发生率(5.88%)低于对照组(23.53%),差异有统计学意义(χ^(2)=4.221,P<0.05);观察组治疗总效率(94.12%)高于对照组(76.47%),差异有统计学意义(χ^(2)=4.221,P<0.05)。结论针对Ⅱ型复杂性区域疼痛综合征患者采取CT引导下射频热凝腰交感神经节治疗,有助于改善血液流变学指标,降低疼痛程度,安全性更高。

Minioptical Navigation System for CT-Guided Percutaneous Liver Procedures

Purpose: To evaluate a new miniature optical navigation system for CT-guided liver interventions. Material and Methods: A two-center, prospective study was performed with four interventional radiologists. A total of 20 patients had CT-guided liver biopsy or ablation interventions utilizing the CT-Guide? navigation system (ActiViews Inc., Wakefield, MA) between July 2011 and December 2011. The navigation system consists of a self-adhesive patientsticker printed with coincident colored and radio-opaque reference markers, a miniature disposable video camera that clips on and off an interventional instrument, and software loaded on a computer to display the navigation information. The primary end point was the frequency of a satisfactory instrument position for the intended intervention. Results: The cohort consisted of 13 males and 7 females with an average age of 63.1 years (range of 38 to 80). Most of the patients, 70%, underwent CT-guided liver biopsy while the remainder had CT-guided ablation therapy. The average lesion size was 3.1 cm (range of 1.1 - 6.9 cm). All of the interventions, regardless of lesion size, met the primary end point of satisfactory instrument positioning. There were no device-related or unexpected adverse events recorded. Only one patient had a mild adverse event and it resolved without intervention. Conclusions: This study demonstrated the safety and effectiveness of the CT-Guide? navigation system for CT-guided liver interventions, for both biopsies and ablations. The targeting success rate for a satisfactory intervention was 100% with the system.

CT-guided percutaneous radiofrequency ablation of spinal osteoid osteoma

Background This study evaluated the feasibility, efficacy and safety of CT-guided percutaneous radiofrequency ablation in patients with spinal osteoid osteoma. Methods Two patients suffered spinal osteoid osteoma were treated with CT-guided percutaneous radiofrequency ablation under local anesthesia. Lesions located in sacral vertebrae and cervical vertebrae, which were adjacent to nerve root and spinal canal respectively. Tumors were treated under 90℃ radiofrequency temperature lasting 4 minutes by an electrode placement. Visual analog scale was used to evaluate the pain improvement. Results No complications were observed pre- and post-operation. Patients recovered to normal activities immediately and achieved complete pain relief in 24 hours. No symptoms were recurrent in 5 months and 4 months follow up. Mild scoliosis has been recovered in case 2. Conclusions CT-guided percutaneous radiofrequency ablation of spinal osteoid osteoma is safe, effective and has more clinical benefits. The long-term outcome needs further observation.

CT三维重建引导低温等离子射频消融联合臭氧及胶原酶治疗腰椎间盘突出症的疗效分析

目的探讨CT三维重建引导低温等离子射频消融联合臭氧和胶原酶治疗腰椎间盘突出症的疗效。方法回顾性选取2019年7月至2020年7月在秦皇岛市第一医院住院治疗的腰椎间盘突出症患者64例,根据治疗方案不同分为观察组和对照组,每组各32例。对照组采用CT三维重建引导低温等离子射频消融联合臭氧注射,观察组在对照组基础上行经骶裂孔入路胶原酶髓核溶解术,术后随访6个月。采用视觉模拟评分法(VAS)评估治疗前和治疗后3 d、1个月、3个月、6个月时疼痛程度。分别测定治疗前和治疗后3 d红细胞沉降率(ESR)、C反应蛋白(CRP)和白细胞计数(WBC)水平。采用改良Macnab标准评定临床疗效,计算治疗后1、3、6个月优良率。观察并记录两组患者随访期间并发症发生情况。结果治疗后,两组患者VAS评分较治疗前均大幅度降低,且观察组治疗后3、6个月时VAS评分为(1.91±1.15)、(1.47±0.76)分,均低于对照组[(3.75±1.50)、(2.38±1.04)分],差异均有统计学意义(P<0.05)。治疗后,两组患者ESR、CRP、WBC均增加,差异均有统计学意义(P<0.05),但两组治疗后上述指标比较,差异均无统计学意义(P>0.05)。观察组治疗后6个月的优良率为87.50%,高于对照组(65.63%),差异有统计学意义(P<0.05)。随访期间,所有患者均无软组织及椎管内血肿、神经受损、腰椎间盘感染等相关并发症发生。结论CT三维重建引导低温等离子射频消融联合臭氧和胶原酶治疗腰椎间盘突出症疗效确切,且安全性较高,具有临床应用价值。

多层螺旋CT测量左心耳形态结构对房颤射频消融术患者左心耳血栓的诊断价值

目的分析多层螺旋CT测量左心耳形态结构对心房颤动(AF)射频消融术患者左心耳血栓的诊断价值。方法选定2020年8月至2022年8月接诊的100例拟行射频消融术治疗的AF患者,分别给予多层螺旋CT、经胸超声(TTE)检查,将实时三维经食管超声心动图(RT-3D-TEE)作为本次研究金标准,比较多层螺旋CT、TTE诊断左心耳血栓准确率、灵敏度、特异度,Kappa检验多层螺旋CT、TTE与RT-3D-TEE的一致性。另选取同期门诊体检中心体检的90例健康体检者做对比,比较左心耳血栓与健康人左心耳以及左心房参数CT测量值。结果多层螺旋CT诊断准确率(98.00%)、灵敏度(98.90%)、特异度(88.89%)均高于TTE(80.00%、86.81%、11.11%),Kappa检验多层螺旋CT与RT-3D-TEE一致性较好(Kappa值=0.573),TTE与RT-3D-TEE一致性一般(Kappa值=0.735)(P<0.05)。左心耳血栓者LAEF、LAEV均低于健康者,左心耳血栓者LAVmax、LAVmin、左心耳长径、短径均高于健康者(P<0.05)。左心耳血栓者LAAEV、LAAEF均低于健康者,左心耳血栓者LAAVmin、LAAVmax均高于健康者(P<0.05)。结论多层螺旋CT在拟行射频消融术AF患者左心耳血栓诊断中准确率、灵敏度以及特异度较高,同时可通过测量左心耳CT参数,对左心耳功能做出评价,具有一定的临床价值。

铍针联合CT引导下脊神经后支脉冲射频消融治疗腰椎骨关节病的临床效果观察

目的观察铍针联合CT引导下脊神经后支脉冲射频消融治疗腰椎骨关节病的临床效果。方法选取2017年5月至2020年5月在首都医科大学附属北京中医医院骨伤科运用铍针联合CT引导下脊神经后支脉冲射频消融治疗腰椎骨关节病的50例患者。所有患者术后随访1年,记录治疗前后视觉模拟量表(VAS)评分,采用改良MacNab标准评价患者治疗后3个月、1年的临床疗效。结果患者治疗后24 h、1周、1个月、3个月、1年VAS评分均低于术前[(2.24±0.94)、(2.00±0.86)、(1.80±0.40)、(1.34±1.30)、(2.14±1.95)分比(6.16±0.77)分],差异均有统计学意义(均P<0.05)。治疗后3个月时患者优良率为84.0%(42/50),1年时患者优良率为72.0%(36/50)。患者术后穿刺部位均未见出血、感染、神经损伤等并发症发生。结论铍针联合CT引导下脊神经后支脉冲射频消融治疗腰椎骨关节病安全有效。

CT引导下热消融联合活检对肺结节的诊断效能

目的探究CT引导下热消融联合活检对不同大小肺结节的诊断效能。方法回顾性分析肺结节患者212例,其中112例患者进行单纯活检(单纯活检组),100例患者进行活检联合热消融(联合组),统计两组患者的技术成功率,记录患者术中、术后出现咯血情况,并记录患者术后出现肺出血、气胸等并发症情况。并以患者所取样本的确切病理诊断结果为准,评估两种方法的诊断准确率。结果两组患者的病理取材均成功进行,技术成功率均达到100%,其中单纯活检组的病理诊断准确率为84.82%,咯血发生率为5.36%,肺出血发生率为28.57%,气胸发生率为22.32%;联合组的病理诊断准确率为87.00%,咯血发生率为1.00%,肺出血发生率为11.00%,气胸发生率为14.00%;其中两组患者的病理诊断准确率、咯血发生率、气胸发生率比较,差异均无统计学意义(χ^(2)分别=0.21、1.93、2.44,P均>0.05),而联合组患者的肺出血发生率明显低于单纯活检组(χ^(2)=10.09,P<0.05)。结论CT引导下热消融联合活检安全、有效,能达到较为良好的诊断准确性。