Alberti Nicolas, Buy Xavier, Frulio Nora, Montaudon Michel, Canella Mathieu, Gangi Afshin, Crombe Amandine, Palussière Jean
Department of Interventional Radiology, Institut Bergonié, Comprehensive Cancer Centre, 229 cours de l'Argonne, 33076 Bordeaux, France.
Department of Radiology, Saint-Andre Hospital, 1 Rue Jean Burguet, 33000 Bordeaux, France.
Eur J Radiol. 2016 Jun;85(6):1181-91. doi: 10.1016/j.ejrad.2016.03.032. Epub 2016 Apr 6.
Among image-guided thermo-ablative techniques, percutaneous radiofrequency ablation (PRFA) is the most widely used technique for the treatment of primary and secondary lung malignancies. Tolerance of PRFA in the lung is excellent. However, relatively little is known about potential rare complications. This article presents both the clinical and imaging features of lung PRFA complications as well as their prevention and management. Complications may be classified in four groups: pleuropulmonary (e.g., bronchopleural or bronchial fistula, delayed abscess or aspergilloma inside post-PRFA cavitations, pulmonary artery pseudo aneurysm, gas embolism and interstitial pneumonia); thoracic wall and vertebral (e.g., rib or vertebral fractures and intercostal artery injury); mediastinal and apical (e.g., neural damage); or diaphragmatic. Most complications can be managed with conservative treatment, percutaneous or endoscopic drainage, or surgical repair.
在图像引导热消融技术中，经皮射频消融（PRFA）是治疗原发性和继发性肺恶性肿瘤应用最广泛的技术。肺对PRFA的耐受性良好。然而，对于潜在的罕见并发症了解相对较少。本文介绍了肺PRFA并发症的临床和影像学特征及其预防和处理。并发症可分为四类：胸膜肺部（如支气管胸膜瘘或支气管瘘、PRFA后空洞内延迟性脓肿或曲霉菌瘤、肺动脉假性动脉瘤、气体栓塞和间质性肺炎）；胸壁和椎体（如肋骨或椎体骨折及肋间动脉损伤）；纵隔和肺尖部（如神经损伤）；或膈肌相关。大多数并发症可通过保守治疗、经皮或内镜引流或手术修复来处理。
