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目的在CT引导下,应用研制的肿瘤四维立体定位精确穿刺弓箭对肺内肿瘤进行定位穿刺和射频消融,观察定位穿刺和射频消融的效果。方法 2010年5月至2012年6月,选择61例患者(69个肿瘤),在CT引导下,利用肿瘤四维立体定位精确穿刺弓箭进行定位和穿刺,利用肿瘤精确放射治疗计划系统,对穿刺到位情况和消融灶范围进行验证评估,采用RITA多极射频肿瘤消融仪对每个肿瘤进行射频消融,采用胸部CT和SPECT对消融效果进行评估。结果 104个肿瘤(较大肿瘤分割后重新计数)定位穿刺均一次完成,无重复穿刺;穿刺误差1~4 mm,平均2.6 mm;104个消融灶完全包含预消融肿瘤。术后1个月复查CT,病灶大小与原肿瘤相比变化不明显,但SPECT显示所有病灶完全无核素浓度。术后3个月复查CT,肿瘤缩小者82.6%(57/69),无肿瘤增大者,3例患者发现肺内转移灶,占4.92%(3/61),复查SPECT,消融灶均无核素浓度。结论利用CT引导和肿瘤四维立体定位精确穿刺弓箭,进行肺内肿瘤定位穿刺和射频消融,定位精确,穿刺准确,锚状电极形成的消融灶可以完全包含肿瘤体积,消融彻底安全。
Objective To study the effect of positioning puncture and radiofrequency catheter ablation (RFA) on the location and location of intracranial tumors with the help of CT guidance. Methods From May 2010 to June 2012, 61 patients (69 tumors) were selected. Under the guidance of CT, accurate positioning and puncture of the bow and arrow using the four-dimensional stereotactic tumor location were performed. Using the precise radiotherapy planning system of the tumor, Condition and extent of the lesion were evaluated and assessed. Each tumor was radiofrequency ablated using a RITA multi-pole radiofrequency ablation instrument and chest ablation and SPECT were used to evaluate ablation. Results Totally 104 tumors (recalculated after larger tumors were divided) were punctured with no puncture. The puncture errors ranged from 1 to 4 mm (mean, 2.6 mm). The 104 lesions included complete ablation of the tumor. One month after the operation, the size of the lesion was not significantly changed from that of the original one. However, SPECT showed no lesions in all the lesions. Three months after the operation, the CT was reviewed. The tumor size was 82.6% (57/69), no tumor size was found. The lung metastases were found in 3 patients (4.92%, 3/61) Nuclide concentration. Conclusions Precisely punctured and radiofrequency ablation of the lung by CT guided and four-dimensional stereotactic localization of the tumor can accurately locate the puncture and radiofrequency ablation. The lesion formed by the anchored electrode can completely contain the tumor volume and completely ablate the ablation.