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目的观察并分析肝癌射频消融(RFA)治疗后磁共振随访信号的动态变化特征。方法回顾性分析2009年1月至2010年12月80例行射频消融治疗的原发性肝癌患者的动态增强MRI资料,根据MRI随访时间分为三组:射频消融治疗后1个月、3~6个月、6个月以后,比较肝癌RFA治疗后不同时间段的MRI表现及动态变化。结果 80例肝癌患者共109个病灶,RFA治疗后1个月,在脂肪抑制FLASH-T1WI上RFA区域全表现为高信号,随着时间延长,RFA区域中心信号呈不同程度下降,6个月后RFA区域中心信号下降与1个月及3~6个月内信号相比,差异均有统计学意义(P<0.05);FSE-T2WI抑脂像上,RFA区域信号随时间延长逐渐呈不均匀性升高,1个月、3~6个月及6个月以后信号比较差异有统计学意义(P<0.05)。增强后早期RFA区域主要表现为边缘线样强化,伴或不伴异常灌注,射频消融完全的病灶,随着时间延长则边缘趋向无强化;局部残留5个、局部进展17个,MRI上表现为边缘不清,伴小结节状异常强化。结论原发性肝癌RFA治疗后,动态增强MRI是显示肿瘤完全坏死、残留或局部进展的有效检查手段。
Objective To observe and analyze the dynamic characteristics of magnetic resonance follow-up signals after radiofrequency ablation (RFA) of liver cancer. Methods The data of 80 patients with primary liver cancer undergoing radiofrequency catheter ablation from January 2009 to December 2010 were retrospectively analyzed. According to MRI follow-up time, the data were divided into three groups: one month after radiofrequency ablation, Six months and six months later, we compared the MRI findings and dynamic changes at different time points after liver cancer RFA treatment. Results A total of 109 lesions were found in 80 patients with hepatocellular carcinoma. RFA in FLASH-T1WI group showed high signal intensity after 1 week of RFA treatment. With the extension of time, the central signal of RFA area decreased to varying degrees. After 6 months RFA regional center signal decline compared with 1 month and 3 to 6 months signal, the difference was statistically significant (P <0.05); FSE-T2WI fat suppression image, RFA region signal over time gradually became uneven There was significant difference in the signal between 1 month, 3 to 6 months and 6 months later (P <0.05). In the early stage of enhancement, the early RFA showed mainly marginal line-like enhancement with or without abnormal perfusion and complete radiofrequency ablation. With the extension of time, the marginal tendencies tended to be no enhancement. Five local and 17 local lesions showed MRI manifestations as Marginal unclear nodules with abnormal enhancement. Conclusions After RFA treatment of primary hepatocellular carcinoma, dynamic contrast-enhanced MRI is an effective means of examining complete necrosis, residual or local tumor progression.