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目的 探讨超声引导射频消融 (radio frequencyablation ,RFA)治疗肝肿瘤中治疗范围与射频针伞径、布针次数之间的关系 ,设计较准确的布针定点定位方法。方法 将肿瘤模式化为类球体 ,根据球体覆盖原理建立数学模型 ,应用正棱柱法及正多面体法进行推导计算 ,获得治疗范围与射频针伞径、布针次数的关系式。根据RFA治疗原则消融范围须超越肿瘤周边 0 .5cm以上 ;按照覆盖类球体肿瘤的计算结果 ,采用伞径 5 .0cm的射频针 ,治疗 4.1～ 4.3cm的肿瘤须用正四面体法至少布针 4个点 ,治疗 4.4～5 .6cm的肿瘤用正棱柱法至少布针 5～ 8个点 ,治疗 5 .7～ 6 .0cm的肿瘤用三层重叠法至少布针 12个点 ,方能达到较彻底覆盖灭活肿瘤的效果。结果 应用上述治疗方案对 32个 3.5～ 6 .6cm的病灶设计布针进行RFA治疗 ,肿瘤灭活率达 84.4%。结论 肿瘤类球体治疗计算方案对RFA治疗中不能一次覆盖的较大肿瘤 ,可提供分区布针方案 ,有助于提高RFA对肝癌的灭活率 ,减少肿瘤残留复发。
Objective To investigate the relationship between the therapeutic range of radio frequency acupuncture and the number of needles guided by ultrasound guided radiofrequency ablation (RFA) in the treatment of hepatic tumors, and to design a more accurate method for locating the needle. Methods The tumors were modeled as spheroids. According to the principle of sphere coverage, a mathematical model was established. The positive prismatic method and the polyhedron method were used to deduce and calculate the relationship between the treatment range and the diameter and the number of needles. According to the principle of RFA treatment, the scope of ablation should exceed 0.5cm around the tumor; in accordance with the calculation of coverage of spheroid tumors, the use of radio-frequency 5 .0cm needle, the treatment of 4.1 ~ 4.3cm of the tumor must be tetrahedron method at least cloth needle 4 points, the treatment of 4.4 ~ 5 .6cm of the tumor with Prism method at least cloth needle 5 to 8 points, the treatment of 5.7 ~ 6 .0 cm of the tumor with three overlapping at least cloth needle 12 points, can only be achieved More thorough coverage of the effect of inactivating the tumor. Results Application of the above treatment regimen for the treatment of 32 3.5-6.6 cm lesions of the needle RFA treatment, tumor inactivation rate of 84.4%. Conclusion The calculation of tumor-like spheroids can not only provide a large tumor that can not be covered once in the treatment of RFA, but also provide a plan of zonal cupping. It can help increase the inactivation rate of RFA on liver cancer and reduce the recurrence of residual tumor.