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目的 :应用螺旋CT评价射频治疗肝癌的近期疗效。方法 :对 35例肝癌 35个病灶射频治疗术前、后肿瘤大小、密度的变化、肿瘤凝固性坏死的形态、范围及术后CT增强扫描的特征进行观察。其中术前进行肝动脉碘油及明胶海绵碎块栓塞 2 3例。结果 :35例肝癌射频术后 5min均有增大 ,术前、后肿块最大径分别为 5 .75± 2 .84cm和 6 .2 2± 1 .1 2cm ,统计学无显著性差异 (P >0 .0 5)。病灶CT值术后 5min均减低 ,术前、后病灶CT值分别为 45 .3± 6 .33Hu和 32 .8± 7.83Hu,均有显著性差异 (P <0 .0 5)。术后 5min 94.2 8% (33/ 35)的病灶呈不同程度凝固性坏死。随访 1～ 1 1个月 ,平均随访 4个月 ,71 % (2 5/ 35)病灶较原病灶缩小 ,2 9% (1 0 / 35)病灶扩大 ,病灶CT值减低 1 1Hu±。CT增强 1 0例 ,其中 5例坏死区表现为无强化 ,5例残留灶 /复发灶显示为结节状或花环状强化。结论 :螺旋CT可准确评价肝癌射频治疗的效果 ,并提示射频结合肝动脉栓塞治疗有助于提高疗效
Objective: To evaluate the short-term curative effect of radiofrequency on hepatocellular carcinoma with spiral CT. Methods: The changes of tumor size and density before and after radiofrequency treatment of 35 lesions of 35 HCC patients were observed. The morphology and extent of tumor coagulation necrosis and the CT postoperative CT scanning were observed. Preoperative hepatic artery lipiodol and gelatin sponge fragment embolism 23 cases. Results: The radiofrequency of 35 cases of hepatocellular carcinoma increased 5 minutes after operation, and the maximum diameter of the tumor before and after operation were respectively 5.75 ± 2.84cm and 6.22 ± 1.12cm, no significant difference (P> 0 .0 5). The CT value of the lesion decreased 5 min after the operation, and the CT values of the lesion before and after the lesion were 45.3 ± 6.33u and 32.8 ± 7.83uu, respectively (P <0.05). After 5 minutes, 94.2% (33/35) lesions showed coagulation necrosis with different degrees. The patients were followed up for 1 to 11 months. The average follow-up was 4 months. 71% (25/35) of the lesions were smaller than the original lesion, 29% (10/35) of the lesions were enlarged, and the lesion CT value was reduced by 1 1Hu ±. CT enhanced 10 cases, of which 5 cases of necrosis showed no enhancement, 5 cases of residual / recurrence showed nodular or rosette-like enhancement. Conclusion: Spiral CT can accurately evaluate the effect of radiofrequency treatment of liver cancer, and suggest that radiofrequency combined with hepatic arterial embolization is helpful to improve the curative effect