[1]刘一铭 许凯豪 焦德超** 吴昆鹏 王朝艳 韩新巍.MR导向经皮微波消融治疗肝癌伴中重度肝硬化[J].中国微创外科杂志,2022,01(10):793-798.
　Liu Yiming,Xu Kaihao,Jiao Dechao,et al.MRguided Percutaneous Microwave Ablation for Hepatocellular Carcinoma With Moderate and Severe Cirrhosis[J].Chinese Journal of Minimally Invasive Surgery,2022,01(10):793-798.
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MR导向经皮微波消融治疗肝癌伴中重度肝硬化()

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2022年10期
页码:
793-798
栏目:
临床研究
出版日期:
2023-01-20

文章信息/Info

Title:
MRguided Percutaneous Microwave Ablation for Hepatocellular Carcinoma With Moderate and Severe Cirrhosis
作者:
刘一铭 许凯豪 焦德超** 吴昆鹏 王朝艳 韩新巍
(郑州大学第一附属医院放射介入科，郑州450052)
Author(s):
Liu Yiming;  Xu Kaihao;  Jiao Dechao;  et al.
Department of Interventional Radiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
关键词:
肝细胞癌; MR导向; 重度肝硬化; 消融治疗
Keywords:
Hepatocellular carcinoma; MR guidance; Severe cirrhosis; Ablation therapy
文献标志码:
A
摘要:
目的评价MR引导经皮微波消融(percutaneous microwave ablation，PMA)治疗肝细胞癌(hepatocellular carcinoma，HCC)伴中重度肝硬化的可行性。方法2019年4月~2021年6月，对26例肝癌伴中重度肝硬化(ChildPugh B级19例，C级7例)在3.0T闭合式MR引导下行PMA。共43枚病灶，最大径(2.86±0.93)cm(0.9~4.8 cm)。术后1个月肝脏增强MR或CT检查评价局部病灶完全消融(complete ablation，CA)或不完全消融(incomplete ablation，ICA)，并随访生存情况。结果40枚病灶消融术中显示清晰，3例膈肌下病灶显示稍欠佳。穿刺需调整10次以上10枚病灶，调整7~10次14枚病灶，调整3~6次16枚病灶，3枚病灶调整1~2次即可。3例(11.5%)轻微并发症。1个月随访，局部CA率95.3%(41/43)，2枚膈肌下病灶(最大径4.8和3.9 cm)为ICA。肿瘤最大径≤3 cm和>3 cm的局部CA率分别为100%(22/22)和90.5%(19/21)。平均随访18.4月(8~26个月)，死亡9例。中位生存期21.0月(95% CI：16.9~25.0)，1年、2年总生存率为92.0%和23.9%。结论3.0T MR引导下PMA治疗肝癌伴中重度肝硬化安全可行，对小肝癌有一定技术优势。
Abstract:
ObjectiveTo evaluate the feasibility and effectiveness of MRguided percutaneous microwave thermal ablation (PMA) for hepatocellular carcinoma (HCC) with moderate and severe cirrhosis.MethodsFrom April 2019 to June 2021, 26 HCC patients with moderate and severe cirrhosis (19 cases with ChildPugh B and 7 cases with ChildPugh C) underwent 3.0T MRguided percutaneous PMA at our department. The maximum diameter of 43 HCC lesions was (2.86±0.93) cm (range, 0.9-4.8 cm). Complete ablation (CA) or incomplete ablation (ICA) was evaluated by enhanced MR or CT examination one month after the operation. Overall survival status was evaluated during the followup period.ResultsA total of 40 lesions were clearly displayed during ablation, and 3 subdiaphragmatic lesions were slightly poorly displayed. Puncture adjustment for more than 10 times was needed at 10 lesions, puncture adjustment for 7-10 times was needed at 14 lesions, 3-6 times at 16 lesions, and 1-2 times at 3 lesions. There were 3 cases (11.5%) of minor complications. The local CA rate was 95.3% (41/43). Two lesions (maximum diameter, 48 cm and 3.9 cm, respectively) under the diaphragm were evaluated as ICA at 1 month followup. The local CA rates of tumors with maximum diameter ≤ 3 cm and > 3 cm were 100% (22/22) and 90.5% (19/21), respectively. The average followup was 18.4 months (range, 8-26 months). Nine cases died. The median survival time was 21.0 months (95% CI: 16.9-25.0), and the 1year and 2year overall survival rates were 92.0% and 23.9%. Conclusion3.0T MRguided PMA is safe and feasible in the treatment of HCC with moderate to severe cirrhosis and has certain technical advantages for small HCC.

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备注/Memo

备注/Memo:
基金项目：2020年河南省中青年卫生健康科技创新杰出青年人才培养项目(YXKC2020037)**通讯作者，Email：jiaodechao007@126.com
更新日期/Last Update: 2023-01-20