Steinke Karin, King Julie, Glenn Derek, Morris David Lawson
Department of Surgery, University of New South Wales and St. George Hospital, Sydney, Australia.
J Comput Assist Tomogr. 2003 Sep-Oct;27(5):750-7. doi: 10.1097/00004728-200309000-00012.
To describe the morphologic appearance over time of percutaneously radiofrequency-ablated pulmonary metastases from colorectal cancer and to focus on the occurrence of the most common complications.
Twenty patients have been treated with computed tomography (CT)-guided radiofrequency ablation (RFA) for 41 pulmonary metastases using the expandable 14-gauge StarBurst XL RF electrode along with the 1500 generator (RITA Medical Systems, Mountain View, CA). The average number of lesions per patient was 2.05, ranging from 1 to 4 lesions.
The typical feature of the radiofrequency-ablated site immediately after the procedure was a light bulb-shaped opacification surrounding the probe. This became a more spherically shaped feature over time and steadily decreased in size. At 3 months after RFA, the lesion was approximately the same size as at baseline. The lesion subsequently shrank within the following 3 months, usually with a small scar remaining. Pneumothorax occurred in 50% of the patients, and a chest tube was required in 50% of the patients affected. Cavitation occurred in 24% of the lesions. Intraparenchymal hemorrhage was observed in 7.5% of the cases.
Image-guided pulmonary RFA is a safe minimally invasive therapy modality with acceptable morbidity. Ablated lesion size usually exceeds the dimensions of the initial tumor for the first 3 months after ablation and continuously shrinks thereafter.
描述经皮射频消融治疗结直肠癌肺转移瘤随时间的形态学表现，并重点关注最常见并发症的发生情况。
20例患者采用可扩张的14G StarBurst XL射频电极联合1500发生器（RITA Medical Systems，加利福尼亚州山景城），在计算机断层扫描（CT）引导下对41个肺转移瘤进行射频消融（RFA）治疗。每位患者的平均病灶数为2.05个，范围为1至4个病灶。
术后即刻射频消融部位的典型特征是探头周围呈灯泡状致密影。随着时间推移，其逐渐变为更接近球形的特征，且大小稳步减小。射频消融术后3个月，病灶大小与基线时大致相同。随后在接下来的3个月内病灶缩小，通常会残留一个小瘢痕。50%的患者发生气胸，其中50%的气胸患者需要放置胸腔引流管。24%的病灶发生空洞形成。7.5%的病例观察到实质内出血。
影像引导下的肺射频消融是一种安全的微创治疗方式，发病率可接受。消融后的病灶大小在消融后的前3个月通常超过初始肿瘤大小，此后持续缩小。
