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目的分析氩氦刀冷冻消融非小细胞肺癌的肺部CT表现。方法选择2013年10月至2015年12月诊断为非小细胞肺癌行氩氦刀冷冻消融治疗患者98例,入组患者均经过病理组织学诊断证实。对比患者治疗前、后肺部CT影像学表现分析其肿瘤消融区影像学特征。结果非小细胞肺癌局部肿瘤冷冻消融影像学表现分为消融即时影像学表现、肺部CT平扫影像学表现以及肺部强化影像学表现。肿瘤冷冻消融即时影像学表现为完全消融区肿瘤呈低密度改变,与周围未消融区肿瘤界限分明。消融后肺部CT平扫显示完全消融区组织呈低密度影像学改变,CT值20~40Hz左右。未消融区肿瘤组织呈等密度改变,CT值20~60Hz左右。肺部CT强化扫描显示完全消融区未见强化表现,而未消融区肿瘤组织呈高密度强化征象。消融后肿瘤组织明显缩小。与治疗前比较肿瘤大小差异具有统计学意义(P<0.05)。结论冷冻消融非小细胞肺癌可以明显减轻肿瘤负荷,减少肿瘤体积。肺部强化CT检查有助于肿瘤消融效果临床评估。
Objective To analyze the pulmonary CT findings of frozen-ablated non-small cell lung cancer with argon-helium knife. Methods From October 2013 to December 2015, 98 patients who were diagnosed as non-small cell lung cancer by cryoablation with argon-helium cryoablation were enrolled. All the patients were confirmed by histopathological diagnosis. Comparing the imaging features of the tumor ablation zone before and after the treatment of patients with CT imaging features. Results The imaging features of frozen-thawed tumors in non-small cell lung cancer were classified into immediate radiological manifestations, CT plain imaging and enhanced lung imaging findings. Tumor cryogenic ablation of real-time imaging showed complete ablation zone tumors showed low density changes, and the surrounding non-ablation zone tumor clear boundaries. Post-ablation CT scan of the lung showed complete radiofrequency ablation of low density imaging changes, CT value of about 20 ~ 40Hz. Tumor tissue did not ablation area was equal density changes, CT value 20 ~ 60Hz or so. Enhanced lung CT scan showed no enhancement of complete ablation zone, while the non-ablation zone tumor showed signs of high density enhancement. Tumor tissue after ablation was significantly reduced. The difference of tumor size before treatment was statistically significant (P <0.05). Conclusion Cryoablation of non-small cell lung cancer can significantly reduce tumor burden and reduce tumor volume. Pulmonary enhanced CT examination contributes to the clinical evaluation of tumor ablation.