MST三维定位导向下周围型肺癌射频消融治疗的临床价值.doc

MSCT三维定位导向下周围型肺癌射频消融治疗的临床价值 山东省潍坊市人民医院261041 目的探讨MSCT三维定位导向下射频消融(RFA)治疗周围型肺癌的临 床应用价值。方法60例周围型肺癌进行了 MSCT三维导向下射频消融治疗。术 前常规MSCT三维导向下经皮穿刺活检获取病理学诊断，腺癌25例，鳞癌20例， 腺鱗癌8例，大细胞癌5例，未分化癌2例。全部瘤体直径均lt;9cm，其中33 个病灶直径lt;5cm。结果全部病例手术顺利，术中并发少量气胸者3例，液 气胸2例，大量气胸行闭式引流者1例。术后分别在3?9个月CT复查，显示 60个病灶中55个体积均有不同程度的进行性缩小，肿瘤内部均出现大片不规则 低密度区；3例患者病灶体积无变化，边缘有环状强化，提示肿瘤复发。结论 MSCT三维定位导向下经皮穿刺RFA治疗周围型肺癌，安全性高，治疗效果好, 值得推广应用。 关键词：计算机断层成像；肺肿瘤；导管消融术；放射学 Clinical value of MSCT three-dimensional guided percutaneous radiofrequency thermalablation of peripheral lung carcinoma ZHANG Kong-yuan HU Qiang Department of Radiology，Weifang people Hospital, Shan dong 261041，China Corresponding author： HU Qiang, Eail： zhangkongyuan @163.com Abstract】0 bjective To investigate the therapeutic value of MSCT three-dimensional guided percutaneous radiofrequency thermal ablation (RFA) for peripheral lung carcinoma (PLC) .Methods 60 patients with PLC were treated with RFA under the MSCT three-dimensional guidance. The patients included 36 males and 24 females, and the age ranged from 56 to 80 years. The MSCT guided percutaneous biopsies were performed to obtain the pathology before the procedures.Results The operations in all caseswere successful, little amount of pneumothorax was found in 3 cases, liquid-pneumothorax in 2case，and large amount of pneumothoraxwas drainaged in 1 case. The volume of the lesion in 55 cases from 60 patientswas diminished gradually at3?9 months follow-up after the procedures. No change in the volume of lesion with peripheral enhancementwas seen in 3 cases.Conclusion MSCT three-dimensional postioned percutaneous RFA for PLC is a safe, effective，and minimal invasive procedure. Key words】computed tomography ； Lung neoplasms； Catheter ablation； Radiology CT引导射频消融术(radiofrequency ablation，RFA)是一种用于 治疗实体肿瘤的微创技术。这项技术最早是在不能切除肝癌的治疗中得到了认可 ［1】。而针对一些因全身情况、心肺功能差无法耐受或不适合手术的肺癌患者， 有文献［2, 3］报道，射频消融术也是一种有价值的治疗选择。本研究采用MSCT引 导射频消融治疗周围型肺癌60例，并评价其可行性、安全性及疗效。 资料与方法 临床资料：搜集我院自2013年2月至2015年9月RFA共治疗周围 型肺癌60例，男36例，女24例；年龄56?80岁