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目的评价开放式 MR 实时导引监测下经皮肝肿瘤冷冻消融治疗的可行性及安全性。方法 16例肝肿瘤患者,在开放式0.23 TMR 扫描仪结合 ipath 200光学导引系统监测下,对16例26个病灶行冷冻消融治疗。冷冻消融术采用氩氦刀(Cryo-Hit),每个靶部位均经2个冷冻、解冻循环。根据肿瘤的大小和位置选择直径2或3 mm 的冷冻探针,对于较大的病灶,同时使用2支冷冻探针。冷冻消融术后24 h 内行1.5 T 常规 MR 增强扫描。术后进行随访。结果冷冻探针准确地穿刺至16例患者的26个病灶的靶点,无严重并发症发生。26个肿瘤病灶共进行26次冷冻消融术,置入30个冷冻探针。术中 MR 能清楚地显示冷冻探针及冰球呈带状和梨形信号缺失,冰球边界清晰。患者术后随访1～24个月,均生存。临床缓解(CR)5例、部分缓解(PR)8例、进展(PD)3例。结论开放式 MR 导引下经皮肿瘤冷冻消融术安全可行。
Objective To evaluate the feasibility and safety of open MR-guided real-time guided monitoring of cryoablation of percutaneous liver tumors. Methods Totally 16 patients with liver cancer were treated with open-ended 0.23 TMR scanner and ipath 200 optical guidance system. Sixteen patients with 26 lesions underwent cryoablation. Cryoablation using Cryo-Hit (Cryo-Hit), each target site after two freezing and thawing cycles. Select a 2 or 3 mm diameter cryoprobe based on tumor size and location, and use two cryoprobes simultaneously for larger lesions. 1.5 T conventional MR enhanced scanning within 24 h after cryoablation. Postoperative follow-up. Results Frozen probe accurately punctured the target of 26 lesions in 16 patients without serious complications. Twenty-six tumor lesions underwent a total of 26 cryoablation procedures and 30 cryoprobes. Intraoperative MR clearly shows that the freezing probe and puck are banded and the pear-shaped signal is missing, and the ice hockey boundary is clear. Patients were followed up for 1 to 24 months, all survived. There were 5 cases of clinical remission (CR), 8 cases of partial remission (PR) and 3 cases of progression (PD). Conclusion Open MR guided percutaneous tumor cryosurgery is safe and feasible.