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超声引导下经皮微波消融治疗肾上腺转移瘤:初步结果。

Ultrasound-guided percutaneous microwave ablation of adrenal metastasis: preliminary results.

机构信息

Department of Ultrasound, Chinese PLA General Hospital, Beijing, China.

出版信息

Int J Hyperthermia. 2009;25(6):455-61. doi: 10.1080/02656730903066608.

Abstract

PURPOSE

To evaluate the feasibility, safety and therapeutic effects of ultrasound (US)-guided percutaneous microwave (MW) ablation in the treatment of adrenal metastasis.

MATERIALS AND METHODS

From May 2006 to April 2008, five consecutive patients with pathologically proven unilateral adrenal metastases with a diameter of 2.3 to 4.5 cm were treated by US-guided percutaneous MW ablation. Four metastases were in the right side, one metastasis was in the left side. For each application, two cooled-shaft needle antennae were percutaneously inserted into the tumour under real-time US guidance. One thermocouple needle was inserted at the periphery of the tumour to monitor temperature in real-time during MW ablation. MW emission was ended when the entire tumour became hyperechoic and the temperature at the tumour border reached 54 degrees C for at least 3 min. Technical success was defined as loss of tumour enhancement on contrast-enhanced imagings.

RESULTS

All adrenal metastases were completely ablated after scheduled MW ablation sessions (mean, 1.2 sessions, range, 1 to 2 sessions). No major complications related to MW ablation occurred. In a median follow-up of 19 months (range 8 to 31 months), persistent absence of tumour enhancement was observed in the treated tumour in all patients.

CONCLUSIONS

US-guided percutaneous MW ablation appears to be a safe and effective therapy in selected adrenal metastasis.

摘要

目的

评估超声引导经皮微波(MW)消融治疗肾上腺转移瘤的可行性、安全性和疗效。

材料与方法

2006 年 5 月至 2008 年 4 月,连续 5 例经病理证实的单侧肾上腺转移瘤患者,直径 2.3 至 4.5cm,接受超声引导经皮 MW 消融治疗。4 例转移瘤位于右侧,1 例位于左侧。对于每个应用,将两根冷轴针天线在实时超声引导下经皮插入肿瘤内。在 MW 消融过程中,在肿瘤边缘插入一根热电偶针以实时监测温度。当整个肿瘤呈高回声且肿瘤边界温度达到 54°C 至少 3 分钟时,MW 发射结束。技术成功定义为肿瘤增强在对比增强成像上的丧失。

结果

所有肾上腺转移瘤均在预定的 MW 消融疗程后完全消融(平均 1.2 个疗程,范围 1 至 2 个疗程)。MW 消融无严重相关并发症。在中位随访 19 个月(范围 8 至 31 个月)期间,所有患者治疗肿瘤的肿瘤增强均持续消失。

结论

超声引导经皮 MW 消融术对选定的肾上腺转移瘤似乎是一种安全有效的治疗方法。

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