摘要
目的探讨肝脏恶性肿瘤射频消融术后早期行^18F脱氧葡萄糖（^18F-FDG）PET—CT复查的临床应用价值。方法15例行射频消融术的肝脏恶性肿瘤患者均在术前2周内行全身PET—CT检查，并于术后24h内行肝区PET—CT复查（早期PET-CT复查），了解消融效果。术后早期PET—CT复查，原病灶区影像上所显示的完全放射性缺损、局部核素浓聚及病灶周围环形核素浓聚分别代表肿瘤彻底坏死、局部肿瘤残留及病灶周围正常肝组织炎症反应。然后分别于术后1、3、6个月行PET-CT复查，6个月以后每隔半年复查一次。以最终的PET—CT检查结果为参考。结果PET-CT早期复查影像显示，12例患者在原肿瘤病灶区表现为完全性放射性缺损，影像随访证实均无肿瘤组织残留；2例表现为病灶边缘结节状的核素浓聚，影像随访证实为残余瘤，并再次治疗干预；1例可见环形轻微核素浓聚，影像随访证实为炎症反应。结论早期PET—CT复查影像，可以避开术后炎症反应的干扰、明确消融范围，能够及时、准确地评价肝脏恶性肿瘤射频消融术的效果，帮助临床制定进一步的治疗方案。
Objective To evaluate the application of early ^18F-FDG PET-CT imaging after radiofrequency ablation （RFA） of hepatic malignancies. Methods Fifteen patients with liver tumors （five hepatocellular carcinoma, ten colorectal cancer liver metastasis ） underwent RFA as part of clinical management. The lesions were all hypermetabolic on PET-CT performed within 2 weeks prior to RFA. All subjects underwent ^18F-FDG PET-CT （early PET-CT） within 24 hours after RFA. Total photopenia, focal uptake, and rim-shaped uptake were regarded as complete ablation, residual tumor, and inflammation, respectively. Follow-up PET-CT scans were performed as the reference standard. Results Twelve patients showed total photopenia at the ablation site on the early PET-CT scan, and in all of these patients, total photopenia at the ablation sites was seen on the fallow-up PET-CT scans. Two patients had focal uptake at the ablation sites on the early PET-CT scan, and both of these loci increased in size and intensity, which were compatible with residual tumors at the time of ablation. Only one patient had rim-shaped uptake on the early PET-CT scan. The rim-shaped uptake disappeared on PET-CT performed 3 months later, which indicated the nature of inflammation. Conclusions There is infrequent inflammatory uptake at the RFA site of liver tumors on lSF-FDG PET-CT if scanning is performed within 24 hours after ablation. Thus ,early PET- CT has the potential to evaluate the efficacy of an RFA procedure by indicating tumor-free as total photopenia and residual tumors as focal uptake.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2009年第5期527-530,共4页
Chinese Journal of Radiology
