Lee Ji Young, Kim Young-sun, Rhim Hyunchul, Lim Hyo K, Choi Dongil, Lee Won Jae
Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
J Comput Assist Tomogr. 2010 May-Jun;34(3):354-61. doi: 10.1097/RCT.0b013e3181cbf43a.
The purpose of this study was to evaluate the pattern and the chronological change of iodized oil retention in a radiofrequency ablation (RFA)-induced vascular injury area as compared with that in recurrent hepatocellular carcinoma (HCC).
Informed consents from all the patients and approval from the institutional review board were obtained. The computed tomographic scans of 226 patients who underwent both RFA and subsequent transcatheter arterial chemoembolization for recurrence were retrospectively reviewed. The RFA-induced vascular injury area that did not have HCC recurrence in it were examined and assessed whether iodized oil was retained after transcatheter arterial chemoembolization. We evaluated the incidence, the shape, and the duration of the iodized oil retention in the RFA-induced vascular injury area and compared them with those found in recurrent HCC from the same patient. The rate of misinterpretation was calculated.
Of 59 RFA-induced vascular injury areas that were within the range of segmental embolization, 33 RFA-induced vascular injury areas (55.9%) in 31 patients retained iodized oil. The shapes of the iodized oil in the RFA-induced vascular injury area were diffuse-dense (n = 13), diffuse-faint (n = 8), nodular-dense (n = 8), or nodular-faint (n = 4). In 29 (93.5%) of 31 patients, at least one recurrent HCC retained iodized oil, and they were all nodular-dense in shape. The duration of the retention in RFA-induced vascular injury area (mean [SD], 3.3 [3.2] months) was significantly shorter than that in recurrent tumors (21.2 [12.5] months, P < 0.001). In 21.2% (7/33) of the cases, the iodized oil density in the RFA-induced vascular injury area was clinically misinterpreted as recurrent HCC.
The RFA-induced vascular injury area frequently retains iodized oil, which could mimic recurrent HCC. However, we determined that iodized oil in the RFA-induced vascular injury area differs from that in HCC in variety in shape and shorter duration of retention.
本研究旨在评估与复发性肝细胞癌（HCC）相比，射频消融（RFA）诱导的血管损伤区域内碘油滞留的模式和时间变化。
获得了所有患者的知情同意书，并得到了机构审查委员会的批准。对226例行RFA及后续经导管动脉化疗栓塞术治疗复发的患者的计算机断层扫描图像进行回顾性分析。检查并评估RFA诱导的无HCC复发的血管损伤区域在经导管动脉化疗栓塞术后是否有碘油滞留。我们评估了RFA诱导的血管损伤区域内碘油滞留的发生率、形态和持续时间，并将其与同一患者复发性HCC中的情况进行比较。计算误诊率。
在节段性栓塞范围内的59个RFA诱导的血管损伤区域中，31例患者的33个RFA诱导的血管损伤区域（55.9%）有碘油滞留。RFA诱导的血管损伤区域内碘油的形态为弥漫致密型（n = 13）、弥漫淡薄型（n = 8）、结节致密型（n = 8）或结节淡薄型（n = 4）。31例患者中有29例（93.5%）至少有一个复发性HCC有碘油滞留，且均为结节致密型。RFA诱导的血管损伤区域内碘油滞留的持续时间（平均[标准差]，3.3 [3.2]个月）明显短于复发性肿瘤（21.2 [12.5]个月，P < 0.001）。在21.2%（7/33）的病例中，RFA诱导的血管损伤区域内碘油密度在临床上被误诊为复发性HCC。
RFA诱导的血管损伤区域常滞留碘油，这可能会被误诊为复发性HCC。然而，我们确定RFA诱导的血管损伤区域内的碘油在形态和滞留持续时间上与HCC中的碘油不同。
