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目的结直肠癌肝转移瘤冷冻消融治疗后CT平扫和动态增强扫描表现。方法选择结直肠癌肝转移瘤的患者39例,病灶数55个,对其中47个病灶行冷冻消融治疗,分别于治疗后即时、3周及3个月行CT平扫和增强扫描,分析其CT表现。结果冷冻消融治疗后CT平扫表现:即时消融区呈椭圆形密度减低区,边缘光滑,较未消融肿瘤区,CT值差异有统计学意义(P<0.05);术后3周消融区呈低密度区与术后3个月平扫CT值差异无统计学意义(P>0.05);增强CT表现:消融中心区各时间点未见强化,CT值无显著性差异(P>0.05)。消融即时边缘未见强化,边缘光滑;术后3周消融区边缘可见规则环状强化环(21/47)例,边缘光滑的弧状强化带(17/47)例,结节状强化影(9/47)例;强化特点呈快进慢出特征;术后3个月,消融区明显缩小,各时间点大小有显著性差异(P<0.05)。边缘未见强化(17/47)例,不规则结节状强化(11/47)例,新月形强化(8/47)例,不规则强化(11/47)例。强化特点呈快进快出强化表现。结论 CT平扫和动态增强扫描评价结直肠癌肝转移瘤冷冻消融的疗效可靠,术后3周以后开始随访对于消融术后残瘤评价具有指导意义。
Objective To evaluate CT scan and dynamic contrast-enhanced scanning of frozen-thawed colorectal carcinoma after liver metastases. Methods Thirty-nine patients with colorectal cancer with liver metastases and 55 lesions were enrolled in this study. Forty-seven of them were treated by cryoablation. CT scan and enhanced scan were performed immediately, 3 and 3 months after treatment respectively. CT performance. Results CT scan after cryoablation showed that the immediate ablation zone showed an oval densified area with a smooth edge. Compared with the non-ablated tumor area, CT value showed significant difference (P <0.05) There was no significant difference in the CT value between the density and 3 months postoperatively (P> 0.05). The enhanced CT showed no significant difference in the CT values at all time points in the ablation center (P> 0.05). The edge of the ablation zone was smooth and smooth at 3 weeks after operation. The regular annular enhancement ring (21/47) was seen at the edge of the ablation zone at 3 weeks after operation. The smooth edge of the arc-like enhancement zone (17/47) / 47). The enhancement characteristics were fast-moving and slow-out characteristics. At 3 months after operation, the ablation zone was significantly reduced, with significant difference at each time point (P <0.05). No enhancement of the edge (17/47), irregular nodular enhancement (11/47), crescent enhancement (8/47), irregular enhancement (11/47). Enhance the characteristics of fast forward fast out to enhance performance. Conclusion The CT scan and dynamic contrast-enhanced scan are reliable in the evaluation of colorectal cancer liver metastases by cryosurgery. Follow-up after 3 weeks can guide the evaluation of postoperative residual aneurysms.