Department of Radiology, Churchill Hospital, Old Road, Oxford, OX3 7LJ, United Kingdom.
Cardiovasc Intervent Radiol. 2013 Apr;36(2):460-5. doi: 10.1007/s00270-012-0465-2. Epub 2012 Sep 12.
To evaluate the technical success, safety, and imaging follow-up of malignant pulmonary nodules treated with a novel high-energy percutaneous microwave ablation (MWA) system.
Between July 2010 and September 2011, a total of 23 patients, 12 men, mean age 68 (range 30-87) years with 29 pulmonary malignancies of median diameter 19 (range 8-57) mm, underwent computed tomography (CT)-guided MWA with a 16G microwave needle antenna enabling power up to 180 W. Technical success was defined as needle placement in the intended lesion without death or serious injury. Adequacy of ablation was assessed at 24 h on contrast-enhanced CT. Circumferential solid or ground glass opacification >5 mm was used to define an ideal ablation. Local tumor recurrence was assessed at 1, 3, and 6 months after ablation on contrast-enhanced CT.
MWA was technically successful in 93 % (n = 27). Mean ablation duration was 3.6 (range 1-9) min. Ten patients (43 %) developed a pneumothorax as a result of the MWA; only 3 (13 %) required placement of a chest drain. Thirty-day mortality rate was 0 %. The mean hospital stay was 1.5 (range 1-7) days. A total of 22 lesions (75 %) were surrounded by ≥5 mm ground glass or solid opacification after the procedure. At a median follow-up of 6 months, local recurrence was identified in 3 out of 26 lesions, giving a local control rate of 88 %.
MWA using a high-power antenna of pulmonary malignancies is safe, technically achievable, and enables fast ablation times.
评估新型高能经皮微波消融（MWA）系统治疗恶性肺结节的技术成功率、安全性和影像学随访结果。
2010 年 7 月至 2011 年 9 月，共 23 例患者（12 名男性，平均年龄 68 岁[范围 30-87 岁]），29 个肺部恶性肿瘤，直径中位数为 19 毫米（范围 8-57 毫米），行 CT 引导下 MWA，使用 16G 微波针天线，最大功率可达 180W。技术成功定义为将针放置在预定病变部位，无死亡或严重损伤。消融充分性在增强 CT 上于 24 小时评估。将 5mm 以上的环形实性或磨玻璃样混浊定义为理想的消融。在消融后 1、3 和 6 个月时，使用增强 CT 评估局部肿瘤复发情况。
93%（n=27）的患者 MWA 技术成功。平均消融时间为 3.6 分钟（范围 1-9 分钟）。10 例（43%）患者因 MWA 发生气胸，仅 3 例（13%）需要放置胸腔引流管。30 天死亡率为 0%。平均住院时间为 1.5 天（范围 1-7 天）。术后 22 个病灶（75%）被≥5mm 的磨玻璃样或实性混浊完全包围。中位随访 6 个月时，26 个病灶中有 3 个出现局部复发，局部控制率为 88%。
使用大功率天线的 MWA 治疗肺部恶性肿瘤是安全的，技术上可行的，并且可以实现快速消融。
