| 赵勇洁,史秋生.超声和CT引导下氩氦刀冷冻治疗恶性肿瘤的临床应用[J].中国医学影像技术,2007,23(2):258~261 |
| 超声和CT引导下氩氦刀冷冻治疗恶性肿瘤的临床应用 |
| Clinical application of the argon helium cryoablation on malignant tumors under the guidance of ultrasound and CT |
| 投稿时间：2006-09-20 修订日期：2006-11-09 |
| DOI： |
| 中文关键词: 冷冻治疗 氩氦刀 超声 体层摄影术,X线计算机 恶性肿瘤 |
| 英文关键词:Cryoablation Argon helium cryoablation Ultrasound Tomography, X-ray computed Malignant tumor |
| 基金项目: |
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| 摘要点击次数: 1986 |
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| 中文摘要: |
| 目的 探讨超声和CT引导下氩氦刀冷冻治疗恶性肿瘤的临床应用价值。方法 无法手术切除或不愿手术切除的恶性肿瘤患者45例49个病灶,在超声或CT引导下进行氩氦刀冷冻治疗,肿瘤分为≤3 cm和＞3 cm两组,观察术中冰球形成和冰球覆盖病灶率、术后病理变化和病灶缩小率。结果 87.5%的冰球在冷冻开始后50 s内形成,声像图表现为横断面上靶区内的弧形强光带后方伴声影,纵断面上靶区内"成角凸起"的强光带后伴声影。随着复温,强光带消失,冷冻区呈不均匀高回声;CT扫描,冷冻消融区为类圆形的低密度区。治疗后组织病理学可见细胞浆疏松、空泡样改变、细胞核固缩、核浓染、核碎裂及溶解。两组术中冰球覆盖率≥80%、＜80%者分别为72.7%、27.3%和26.3%、73.7%,两组冰球覆盖率差别有显著性意义(P＜0.05)。术后3个月,≤3 cm和＞3 cm两组中,病灶缩小率≥50% 的分别占81.8%和28.9%,两组病灶缩小率差别有极显著性意义(P＜0.01)。结论 超声和CT引导下氩氦刀冷冻治疗恶性肿瘤,定位准确,影像学改变明显、疗效确切、安全可靠, 特别对小病灶效果显著。 |
| 英文摘要: |
| Objective To study the clinical application of the argon helium cryoablation on malignant tumors under the guidance of ultrasound or CT. Methods Forty-five patients with 49 foci of malignant tumors, who were not fit to surgical resection or were reluctant to be taken the operation, were treated with Cryo-HitTM cryotherapy system under the guidance of ultrasound or CT. The patients were divided into ≤3 cm and ＞3 cm groups in size. The ice-balls and its coverage, the histopatholoy and the shrinkage were observed post cryoablation. Results The ice-balls were demonstrated within 50 seconds after cryoablation in 87.5% cases. And the arc and angled arc hyperechogenity with shadow were sonographically showed on the trans- and longitudinal cryoablation section, respectively. With the temperature went up, the arc hyperechogenity with shadow became gradually weak to disappear. At the result, the inhomogeneous echogenity were seen in the cryoablated area. The hypodensities were seen at cryoablated area on the CT imaging. The various changes were histopathologically seen, such as the loose cytoplasm, vacuole degeneration, pyknosis, karyorrhexis, karyolysis, etc. The ice-ball coverage was significantly different in the two groups. The possibility value is less than 0.05. The shrinkage of the cryoablated lesions was more significantly different. The possibility value is less than 0.01. Conclusion The cryoablated treatment was safe and effective and helpful to patients with the malignant tumors under the guidance of ultrasound or CT, especially for the patients in early stage. |
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