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目的探讨射频消融术(RFA)后肿瘤血管改变与疗效的相关性及残癌的监控。方法35例肝脏肿瘤41个病灶,在接受RFA术后1~12月行CT、肝动脉及间接门静脉造影检查,根据术后CT及DSA造影表现及临床随访,评估RFA术的疗效,并对残留及再生肿瘤病灶实施介入干预。结果RFA术后,在12个月的随访中,24个病灶完全坏死;17个病灶出现残留,13个出现肿瘤再生,表现为残留的肿瘤血管和肿瘤染色,以及新生肿瘤血管和不规则新肿瘤染色灶。经过肝动脉化疗和栓塞治疗后,残留和再生病灶得到控制。结论肝脏肿瘤的供血血管的再通或血管的再生(侧支循环的产生),与肿瘤残留及再生有直接相关性,DSA血管造影应作为监控肿瘤残留的金标准。
Objective To investigate the correlation between tumor vascular changes and efficacy after radiofrequency ablation (RFA) and the monitoring of residual cancer. Methods Forty-one lesions of 35 patients with liver tumors were examined by CT, hepatic artery and indirect portal vein angiography from January to December after RFA. The efficacy of RFA was evaluated according to CT and DSA angiographic findings and clinical follow-up. And interventional interventions for regenerating tumor lesions. Results After RFA, at 24 months follow-up, 24 lesions were completely necrotic; 17 lesions remained, and 13 tumors regenerated, showing residual tumor vascular and tumor staining, as well as neonatal tumor vessels and irregular neoplasms. Staining stove. After hepatic arterial chemotherapy and embolization, residual and regenerative lesions were controlled. Conclusions The recanalization of blood supply to the liver tumors or the regeneration of blood vessels (production of collateral circulation) has a direct correlation with tumor remnants and regeneration. DSA angiography should be used as the gold standard for monitoring tumor residuals.