摘要
目的探讨肝动脉造影CT(CTHA)引导下射频消融治疗多结节型结直肠癌肝转移灶的安全性及疗效。方法回顾性分析2020年3月至2021年9月在郑州大学附属肿瘤医院行经股动脉置管并在CTHA引导下行经皮射频消融治疗的32例结直肠癌肝转移患者的临床资料,其中男性21例,女性11例,年龄(53.2±9.9)岁。患者消融前在数字减影血管造影(DSA)下将造影导管留置于肝总动脉或肝固有动脉,随后转至CT手术室,全麻后经造影导管注入对比剂,行CTHA引导下的经皮射频消融治疗。观察消融术中病灶的呈现情况、术中对比剂总用量、并发症发生情况并随访治疗效果。以门诊或住院方式进行随访。结果32例患者均顺利完成了DSA引导下的动脉置管,共涉及97处病灶,均在CTHA引导下顺利完成射频消融术,技术成功率为100%(97/97)。病灶强化处的CT值与病灶旁肝实质CT值的差值均≥25 HU,术中每例患者对比剂总用量为(63.9±14.7)ml。所有消融相关并发症均为美国介入放射学会并发症分级标准中的A、B级。消融后术中CTHA评估的完全消融率为100%(97/97)。术后1个月行MRI示32例患者的97处病灶均未见活性征象,肿瘤完全坏死率为100%(97/97)。所有患者均完成随访,截至随访结束,97处消融病灶均未见复发。结论CTHA引导下的射频消融治疗多结节型结直肠癌肝转移灶安全可行,有助于降低消融后病灶的局部复发率。
Objective To evaluate the safety and efficacy of radiofrequency ablation guided by CT hepatic arteriography(CTHA)in the treatment of multiple nodular liver metastases of colorectal cancer.Methods Clinical data of 32 patients with liver metastasis of colorectal cancer who underwent femoral arterial catheterization and percutaneous radiofrequency ablation guided by CT hepatic arteriography(CTHA)at the Affiliated Cancer Hospital of Zhengzhou University from March 2020 to September 2021 were retrospectively analyzed,including 21 males and 11 females,aged(53.2±9.9)years old.Before ablation,the angiography catheter were placed in the common or proper hepatic artery under the digital subtraction angiography(DSA).The patients were then transferred to a CT operating room.Under general anesthesia,contrast agent was injected into the indwelling angiography catheter and percutaneous radiofrequency ablation guided by CTHA was performed.The presentation of lesions,the dosage of contrast agent and complications during ablation were analyzed,and the treatment outcome was followed up outpatient or inpatient review.Results All 32 patients uneventfully underwent DSA-guided angiography catheter placement,and CTHA-guided radiofrequency ablation was successfully performed in 97 lesions,with a technical success rate of 100%(97/97).The difference between CT values at the lesion enhancement site and peri-tumor hepatic parenchyma were greater than 25 HU.The total amount of contrast agent used during the procedure was 63.9±14.7 ml.All ablation-related complications were graded as A or B according to the Society of Interventional Radiology classification system.The complete ablation rate assessed by CTHA after the ablation was 100%(97/97).The rate of lesion necrosis was 100%evaluated by MRI one month after ablation.All patients were followed up and no recurrence was observed in 97 ablated lesions by the end of follow-up period.Conclusion Radiofrequency ablation guided by CTHA is safe and feasible for the treatment of multiple nodular live
作者
耿翔
黎海亮
郭晨阳
胡鸿涛
程洪涛
姚全军
郑琳
赵可
Geng Xiang;Li Hailiang;Guo Chenyang;Hu Hongtao;Cheng Hongtao;Yao Quanjun;Zheng Lin;Zhao Ke(Department of Minimally-Invasive Intervention,the Affiliated Cancer Hospital of Zhengzhou University(Henan Cancer Hospital),Zhengzhou 450008,China)
出处
《中华肝胆外科杂志》
CAS
CSCD
北大核心
2023年第6期423-427,共5页
Chinese Journal of Hepatobiliary Surgery
基金
河南省医学教育研究项目(Wjlx2021336)
河南省自然科学基金面上项目(212300410403)。
关键词
射频消融术
肝动脉造影CT
局部复发率
Radiofrequency ablation
CT hepatic arteriography
Local recurrence rate
