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微创治疗在肝脏肿瘤管理中的当前作用。

The current role of minimally invasive therapies in the management of liver tumors.

作者信息

Rempp Hansjörg, Boss Andreas, Helmberger Thomas, Pereira Philippe

机构信息

Department on Diagnostic and Interventional Radiology, Eberhard Karls University Hospital of Tübingen, Hoppe-Seyler-Strasse 3, 72076, Tübingen, Germany.

出版信息

Abdom Imaging. 2011 Dec;36(6):635-47. doi: 10.1007/s00261-011-9749-2.

Abstract

This is a review of minimally invasive therapy options for liver tumors, such as highly focused ultrasound, microwave ablation, and irreversible electroporation, as well as new aspects of radiofrequency ablation. Radiofrequency ablation is recommended for patients with early-stage HCC with up to 3 lesions with a tumor diameter within 3 cm and for patients with non-resectable liver metastasis. Indications and contraindications to treatment are designated, and different modalities for image-based therapy guidance are compared. Options for therapy monitoring and controlling are reviewed, namely intraprocedural tools, imaging and functional parameters and their evolution during therapy. Prevention and control of local recurrences is discussed. We also present a short review of current clinical results in treating liver metastasis and primary liver tumors.

摘要

本文综述了肝肿瘤的微创治疗方法,如高强度聚焦超声、微波消融和不可逆电穿孔,以及射频消融的新进展。推荐对肿瘤直径在3cm以内、最多3个病灶的早期肝癌患者以及不可切除的肝转移患者进行射频消融治疗。明确了治疗的适应证和禁忌证,并比较了基于图像的治疗引导的不同方式。回顾了治疗监测和控制的方法,即术中工具、影像学和功能参数及其在治疗过程中的变化。讨论了局部复发的预防和控制。我们还简要综述了目前治疗肝转移和原发性肝肿瘤的临床结果。

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