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目的探讨磁共振动态增强扫描在评价肝癌射频消融治疗效果中的价值。方法对18例(5例为多发病灶,总共25个病灶)进行射频消融治疗的肝癌患者定期进行磁共振动态增强随访,观察射频消融的效果及肿瘤复发情况。结果射频消融治疗肝癌术后病灶随时间改变而其磁共振表现各有不同。病灶早期(1个月内)呈典型的三层圆心圆改变,静脉注射Gd-DTPA后中央区无强化,而边缘则呈环行强化。3-6个月随访23个病灶为TlW及T2W均呈低信号,且无强化。2个病灶消融区边缘出现结节状强化或较厚的不规则环状强化。结论射频消融对于合适的肝癌癌灶是一种疗效确切的局部治疗方法,在评价其疗效及长期随访中磁共振动态增强扫描是一种非常有效的检查手段。
Objective To investigate the value of dynamic contrast-enhanced magnetic resonance (MRI) in the evaluation of radiofrequency ablation of liver cancer. Methods 18 patients (5 patients with multiple lesions, a total of 25 lesions) were treated with radiofrequency ablation. The patients underwent MR dynamic enhanced follow-up to observe the radiofrequency ablation and tumor recurrence. Results Radiofrequency ablation for the treatment of liver cancer lesions over time changes and their magnetic resonance performance are different. In the early stage of the lesion (within 1 month), the typical three-layer circle center changed. There was no enhancement in the central area after Gd-DTPA intravenous injection, while the edge was enhanced in the circular. Twenty-three months after follow-up, 23 lesions showed low signal intensity on TlW and T2W without any enhancement. Two lesions at the edge of the ablation zone showed nodular or thick irregular ring enhancement. Conclusion Radiofrequency ablation (RFA) is an effective local treatment for hepatocellular carcinoma. It is a very effective method to evaluate the efficacy and dynamic contrast-enhanced MR imaging in long-term follow-up.