小肝癌射频消融治疗后早期MR表现-论文.pdf

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1、医学影像学杂志2014年第24卷第8期JMedImagingVo1．24No．82014小肝癌射频消融治疗后早期MR表现曲蕾，陈晓飞，王淑艳，陈立光，袁振国，赵斌(1．山东大学山东省医学影像学研究所山东济南250021；2．泰山医学院山东泰安27i000)【摘要】目的探讨磁共振平扫和动态强化扫描在评估小肝癌射频消融(radiofrequencyablation，RFA)治疗后疗效的价值。方法63例小原发性肝细胞癌75个肿瘤病灶射频消融前、后行48h内MRI常规、动态增强扫描并观察各序列信号变化。结果完全消融73个，48h内在GRE—TwI射频消融区域全表现为高信号，TSE—T。wI

2、及TSE—T。wI抑脂像表现为相对低信号，增强后早期射频消融区域主要表现为环状强化。2个伴残存癌细胞，表现为伴边缘小结节状小GRE—TwI略低信号、SE—T2wI稍高信号并伴有中等度或明显动脉期强化。结论常规MRI扫描，联合动态强化对评价小肝细胞癌消融治疗的疗效及检测肿瘤残存具有重要作用，可成为早期随访的可靠方法。【关键词】射频消融；磁共振成像；原发性肝细胞小肝癌中图分类号：R735．7；R445．2文献标识码：A文章编号：1006—9011(2014j08—1327—03MRIearlyperformanceofprimarySHCCaftertreatmentbyradiofr

3、equencyablationQULei，CHENXiao—fei，WANGShu—yan，CHENLi—guang，YAUNZhen—guo，ZHAOBin1．ShandongMedicalImagingResearchInstitute，ShandongUniversity，ShahdongProvince250021，P．R．China2．Imagingcenter，TaishanMedicalUniversity，ShandongProvince271000，P．R．China[Abstract]ObjectiveToinvestigatethefeasibilityofm

4、agneticresonanceimaging(MRI)toassesstheearlyeffectivityafterthetreatmentofradiofrequencyablation(RFA)forsmallprimaryhepatocellularcarcinoma(SHCC)．Methods75lesionsofsmallprimaryhepatocellularcarcinoma(SHCC)in63caseswereexaminatedinroutineanddynamicenhance—mentMRIbeforeandwithin48haftertreatment

5、ofradiofrequencyablation，andthechangesofsequencesignalwereob—served．ResultsSeventythreeRFAareasof63patientstypicallyexhibitedhyperintensityonT1WIandhypointensityonT2W1within48hafterablation．Oncontrast，inenhancedMRimages，RFAlesionswereshownperipheralrimofan—hancementwithin48h．Thetworesidua1tumo

6、rnodular1esionswerefoundattheperipheryoftheRFA．Thesenodularle—sionswereshownmoderatetomarkedenhancementaswellashypointensesignalonTlWI，andmoderatehyperintensesig—nalonT2WI．ConclusionRoutineMRImaybeoneofimagingmethodsforeffectivelyassessingtheearlyeffectofRFAonSHHCtreatedbyRFA．RoutineplainMRIco

7、mbinedwithcontrastenhancedMRImayimprovethecucuracyofrecur—fenceinSHCCafterRFAtreatment．[Keywords]Radiofrequencyablation；Magneticresonanceimaging(MRI)；SmallPrimaryhepatocellularcarcinoma目前射频凝固作为治疗肿瘤的方法，已逐渐用鉴别诊断水平，为临床判断疗效提供客观评判依据。于肝癌的临床治疗