倾斜穿刺技术在射频消融治疗膈顶肝癌应用.docVIP

倾斜穿刺技术在射频消融治疗膈顶肝癌应用 　　【摘要】 目的 探讨倾斜穿刺技术在CT引导下冷循环射频消融(RFA)治疗膈顶部肝癌的应用价值。 方法 在CT引导下运用倾斜穿刺技术穿刺19例肝癌患者共21个膈顶部病灶，并进行冷循环RFA术，术后复查增强CT或MR, 观察病灶坏死情况。结果 19个病灶完全坏死，2个病灶大部分坏死，病灶完全坏死率90.5%，无严重并发症。结论 应用CT引导下倾斜穿刺技术RFA治疗膈顶部肝癌效果满意，值得进一步的研究和总结。? 　　【关键词】 　　射频消融；CT引导；横膈；肝癌；穿刺术 　　?? 　　 　　The application of slant paracentesis in radiofrequency ablation for liver cancer located under the diaphragm 　　 　　WU Yu?xuan, ZHANG Yan?fang,FENG E?xiang, et al. 　　DepartmentofInterventional Radiology, Shenzhen People?sHospital, The Second Clinical Medical College of Jinan University, Shenzhen，518020, China 　　? 　　 　　【Abstract】 Objective To investigate the application value of slant paracentesis in the treatment of liver cancer located under the diaphragm with cool?tip radiofrequency ablation(RFA) percutaneously under CT guidance. Methods 19 patients with total 21 lesions located under the diaphragm were treated by CT?guided RFA with cool?tip electrode. The slant paracentesis was carried out for each lesion. The postoperative efficacy was evaluated by enhanced CT or MR. Results The paracentesis achievement ratio was 100%. 90.5% lesions were completely necrotized(19/21), 2 lesions were majority necrotized. No severe complications occurred. Conclusion The effectiveness of slant paracentesis in CT?RFA for liver cancer located under the diaphragmis satisfied and a further studyis worthy to continue.? 　　【Key words】 　　Radiofrequency ablation； CT?guided； Diaphragm； Liver cancer；Paracentesis 　　膈顶部肝癌是RFA的难点之一［1?2］，本科运用CT引导下从足侧向头侧倾斜的穿刺技术穿刺膈顶部肝癌，并进行RFA治疗，效果满意，报告如下。? 　　1 资料与方法? 　　1.1 一般资料 　　我科2005年3月至2006年9月运用CT引导下倾斜穿刺技术穿刺膈顶部肝癌，并进行冷循环RFA术共19例患者21个病灶，其中原发性肝癌14例16个病灶，胆管细胞癌术后复发3例，乳腺癌肝转移1例，结肠癌术后肝转移1例，7个原发性肝癌病灶RFA前曾行1次TACE术，余14个病灶为直接RFA术。病灶纳入标准：① 病灶最大径≤5.0cm。②病灶与膈肌距离≤1.0 cm。③病灶中心点不低于在左、右肋膈角连线。患者中男17例，女2例，年龄38~74岁，中位年龄60岁。病灶最大径0.8~5.0 cm，平均3.0cm，其中 本文为全文原貌 未安装PDF浏览器用户请先下载安装 原版全文 　　 　　? 　　图1 　　图2 　　图3 　　图4? 　　 　　图1 层面1，病灶中心为O? 　　图2 层面2在层面1足侧4 cm，B为穿刺进针点，BO为穿刺路径，OE为层面1和层面2之间的距离， AO为B