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目的回顾性分析肝癌经皮射频消融术(PRFA)后特殊征象CT表现对于正确评价PRFA疗效的影响。方法 2002年1月至2011年6月,630例肝癌患者(共726个结节)行PRFA术,术后3个月内行首次增强CT检查评价疗效,结合随访结果探讨术后特殊征象CT表现对于PRFA疗效影响。结果 662个(91.2%)病灶在接受PRFA治疗后3个月内作增强CT检查被评价为完全消融,增强扫描未见强化;残留灶可见增强对比剂“快进快出”表现。PRFA术后特殊CT表现有:早期肝脓肿(1例);假性动脉瘤(8例);胆汁湖(12例);异常灌注(23例);中央高密度影(46例);良性炎性反应带(27例)与消融灶中央气体(2例)。部分特殊征象对疗效评价构成影响。结论增强CT能有效评价PRFA疗效,正确理解PRFA术后部分特殊征象CT表现有利于提高其疗效评价的正确率。
Objective To retrospectively analyze the effect of special signs of CT on the evaluation of the efficacy of PRFA after percutaneous radiofrequency ablation (PRFA) of liver cancer. Methods From January 2002 to June 2011, 630 patients with hepatocellular carcinoma (726 nodules in total) underwent PRFA. The patients underwent the first enhanced CT examination within 3 months after operation. The CT findings of the postoperative special signs were evaluated with the follow-up results PRFA efficacy effect. Results 662 (91.2%) lesions underwent enhanced CT within 3 months after PRFA treatment. The CT scan was evaluated as complete ablation and no enhancement was seen in the enhanced scan. Enhanced contrast agent “fast-forward-fast-forward” performance was observed in residual lesions. PRFA postoperative special CT manifestations: early liver abscess (1 case); pseudoaneurysm (8 cases); bile lake (12 cases); abnormal perfusion (23 cases); central high density (46 cases); benign inflammation The reaction zone (27 cases) and the central gas of the lesion (2 cases). Some special signs of impact on the evaluation of the effect. Conclusions Enhanced CT can effectively evaluate the efficacy of PRFA. To correctly understand the CT features of some special signs after PRFA is beneficial to improve the accuracy of its evaluation.