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技术上成功的肾冷冻消融术后的 MRI:早期对比增强是常见表现。

MRI after technically successful renal cryoablation: early contrast enhancement as a common finding.

机构信息

Department of Radiology, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA.

出版信息

AJR Am J Roentgenol. 2010 Mar;194(3):790-3. doi: 10.2214/AJR.09.2518.

Abstract

OBJECTIVE

The purpose of this study was to assess the MRI appearance and enhancement of renal masses within 36 hours after cryoablation.

MATERIALS AND METHODS

From March 2003 through January 2008, 129 patients underwent imaging-guided cryoablation for renal masses. Twenty-three of these patients underwent MRI within 36 hours after ablation. During MRI, acquisition of axial T1- and T2-weighted images was followed by administration of a gadolinium contrast agent. Standard follow-up included MRI 3-6 months after ablation.

RESULTS

Eight of the 23 renal masses imaged within 6-36 hours after ablation were enhanced on MR images. Five of the eight lesions exhibited homogeneous enhancement, and the other three had heterogeneous or rim enhancement. Seven of the eight lesions exhibited no enhancement at the 6-month follow-up examination. One patient underwent follow-up imaging 10 months rather than 3-6 months after the procedure, but no enhancement was seen. T2-weighted signal intensity was mixed among the 23 renal masses. T1-weighted signal intensity was mixed among the 23 renal masses and the eight lesions that became enhanced, but there was a trend for higher T1 signal intensity at the 3- to 6-month follow-up examination.

CONCLUSION

The high proportion of enhancing lesions 3 months after treatment and the resolution of enhancement 6 months afterward suggest that it may be reasonable to wait 6 months after technically successful renal cryoablation before performing contrast-enhanced MRI.

摘要

目的

本研究旨在评估冷冻消融术后 36 小时内肾脏肿块的 MRI 表现和增强情况。

材料与方法

2003 年 3 月至 2008 年 1 月,129 例患者因肾脏肿块接受了影像引导下的冷冻消融术。其中 23 例患者在消融术后 36 小时内行 MRI 检查。在 MRI 检查期间,首先采集轴位 T1 加权和 T2 加权图像,然后给予钆造影剂。标准随访包括消融后 3-6 个月的 MRI 检查。

结果

在消融后 6-36 小时内进行 MRI 成像的 23 个肾脏肿块中,有 8 个在 MR 图像上增强。8 个病变中的 5 个呈均匀增强,另外 3 个呈不均匀或边缘增强。在 6 个月的随访检查中,7 个病变无增强。1 例患者在手术后 10 个月而不是 3-6 个月进行了随访影像学检查,但未见增强。23 个肾脏肿块的 T2 加权信号强度混杂。23 个肾脏肿块和 8 个增强病变的 T1 加权信号强度混杂,但在 3-6 个月的随访检查中,T1 信号强度有升高的趋势。

结论

治疗后 3 个月增强病变的比例较高,6 个月后增强消退,这表明在技术上成功的肾脏冷冻消融术后等待 6 个月再行增强 MRI 可能是合理的。

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