磁共振引导下经皮冷冻消融治疗肝细胞癌的疗效

Outcome of MR-guided percutaneous cryoablation for hepatocellular carcinoma.

作者信息

Shimizu Tadashi, Sakuhara Yusuke, Abo Daisuke, Hasegawa Yu, Kodama Yoshihisa, Endo Hideho, Shirato Hiroki, Miyasaka Kazuo

机构信息

Department of Biomedical Science and Engineering, Faculty of Health Sciences, Hokkaido University, North-12 West-5, Kita-ku, Sapporo, 060-0812, Japan.

出版信息

J Hepatobiliary Pancreat Surg. 2009;16(6):816-23. doi: 10.1007/s00534-009-0124-4. Epub 2009 May 23.

DOI:10.1007/s00534-009-0124-4

PMID:19466377

Abstract

PURPOSE

To assess the mid-term results of MR-guided percutaneous cryoablation for small hepatocellular carcinoma (HCC).

METHODS

Using an argon-based cryoablation system, MR-guided percutaneous cryoablation was performed. The number of tumors was three or fewer. The maximum diameter of tumors was less than 5 cm when solitary and no more than 3 cm when multiple. The Kaplan-Meier method was used to calculate the survival of patients.

RESULTS

Among 15 patients, 16 tumors were treated. The maximum tumor diameter ranged from 1.2 to 4.5 cm, with a mean of 2.5 +/- 0.8 cm (mean +/- standard deviation). The volume of iceballs measured on MR-images was greater than that of the tumors in all cases. The follow-up period ranged from 10 to 52 months, with a mean of 36.6 +/- 12.1 months. One-year and 3-year overall survival were 93.8 and 79.3%, respectively. The complete ablation rate was 80.8% at 3 years. Immediate complications were pneumothorax, hemothorax, and pleural effusion. An ablation zone was not absorbed and content exuded from a scar of the probe tract 4 months after cryoablation in one patient.

CONCLUSION

MR-guided percutaneous cryoablation appears to be a feasible modality and potentially good option for the treatment of small HCC.

摘要

目的

评估磁共振引导下经皮冷冻消融治疗小肝癌（HCC）的中期结果。

方法

使用基于氩气的冷冻消融系统进行磁共振引导下经皮冷冻消融。肿瘤数量为3个或更少。单发肿瘤的最大直径小于5 cm，多发肿瘤的最大直径不超过3 cm。采用Kaplan-Meier法计算患者生存率。

结果

15例患者共治疗16个肿瘤。肿瘤最大直径为1.2～4.5 cm，平均为2.5±0.8 cm（平均值±标准差）。所有病例磁共振图像上测量的冰球体积均大于肿瘤体积。随访时间为10～52个月，平均为36.6±12.1个月。1年和3年总生存率分别为93.8%和79.3%。3年时完全消融率为80.8%。即刻并发症为气胸、血胸和胸腔积液。1例患者在冷冻消融4个月后，消融区未吸收，探针通道瘢痕处有内容物渗出。