Bertolotto Michele, Campo Irene, Sachs Camilla, Ciabattoni Riccardo, Cicero Calogero, Drudi Francesco Maria, Derchi Lorenzo E, Cova Maria Assunta
Department of Radiology, University of Trieste, Ospedale di Cattinara, Trieste, Italy.
Department of Radiology, Ospedale Civile di Conegliano, ULSS 2 Marca Trevigiana, Conegliano (TV), Italy.
J Med Imaging Radiat Oncol. 2021 Jun;65(3):272-278. doi: 10.1111/1754-9485.13149. Epub 2021 Feb 6.
To investigate how long successfully ablated tumours take to become completely avascular at CEUS after cryoablation.
Ninety-five patients had percutaneous cryoablation of 103 renal tumours investigated at CEUS on post-operative day one. If the lesion was avascular, a contrast-CT/MR was scheduled six months after the procedure, while CEUS was repeated if the lesion still displayed enhancement, until the disappearance of intralesional vascularity. Technical success was defined when the tumour was covered completely by the ablation zone. Technique efficacy was assessed at six months of follow-up.
Technical efficacy was obtained for 101/103 cryoablations, 56% of which (57/101) were avascular on post-operative day one. After one week, two weeks, one month 83%, 91% and 100% of these 101 lesions, respectively, were avascular. Two tumours were unsuccessfully treated. They displayed persistent intralesional vascularity at CEUS one month after the procedure.
After cryoablation, obtaining CEUS before one month may be misleading. When technical efficacy is obtained, disappearance of intralesional enhancement is observed within two weeks in the majority of cases (91%), but can persist until one month. Identification of tumour enhancement after one month may be concerning for residual viable tumour.
探讨冷冻消融术后成功消融的肿瘤在对比增强超声（CEUS）检查时需要多长时间完全无血管化。
95例患者接受了103个肾肿瘤的经皮冷冻消融治疗，并于术后第一天接受CEUS检查。如果病变无血管，则在术后6个月安排对比增强CT/磁共振成像（MR）检查；如果病变仍显示强化，则重复进行CEUS检查，直至病灶内血管消失。当肿瘤完全被消融区覆盖时定义为技术成功。在随访6个月时评估技术疗效。
103次冷冻消融中有101次获得了技术疗效，其中56%（57/101）在术后第一天无血管。在这101个病灶中，1周后、2周后、1个月后分别有83%、91%和100%无血管。2个肿瘤治疗失败，在术后1个月的CEUS检查中显示病灶内持续存在血管。
冷冻消融后，在1个月内进行CEUS检查可能会产生误导。当获得技术疗效时，大多数病例（91%）在2周内观察到病灶内强化消失，但可能持续至1个月。1个月后发现肿瘤强化可能提示存在残留的存活肿瘤。
