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目的探讨肺部恶性肿瘤氩氦刀术后多个时间点CT表现及其变化特点。方法前瞻性于术前、术后1天、1周、1个月、3个月、6个月、12个月对接受氩氦刀治疗的26例肺部恶性肿瘤患者(共29个结节)行CT平扫和双期增强扫描,包括14例单发肺癌患者和12例共15个结节的肺转移瘤患者。两名阅片者独立阅片,测量最大横截面积和平扫及增强CT值,配对t检验比较相邻时间点病灶大小和CT值差异,并观察有无空洞、边缘低密度环和并发症。结果 12个月随访周期内总体治疗有效率为86.2%(25/29)。术后1个月,10个(34.5%)消融区内形成空洞。术后1天,16个(55.2%)消融区边缘形成气体样低密度环,并在术后3个月吸收。有效组术后消融区面积持续缩小,术后平扫CT值逐渐下降且无明确强化。4个PD组病灶表现为面积增大,平扫CT值增高并强化,未见空洞和边缘低密度环征象。结论消融区面积逐渐缩小,平扫CT值持续下降且增强扫描CT值增幅<15 HU,术后消融区边缘存在低密度环、空洞形成等有助于判断病灶进展,CT在识别消融区及动态反映其变化方面具有重要价值。
Objective To investigate the CT findings and its changes at different time points after cryoablation of lung cancer. METHODS: Twenty-six patients with lung cancer who received argon-helium knife surgery (29 nodules in total) were prospectively preoperatively, 1 day, 1 week, 1 month, 3 months, 6 months and 12 months after operation. ) Underwent CT plain scan and double-phase enhanced scan, including 14 patients with solitary lung cancer and 12 patients with pulmonary nodules with 15 nodules. Two readers read the images independently, measured the maximum cross-sectional area, and scanned and enhanced CT values. The paired t-test compared the lesion size and CT value at adjacent time points and observed the presence of empty and marginal low-density rings and complications. Results The overall response rate was 86.2% (25/29) during the 12-month follow-up period. One month after operation, 10 (34.5%) cavities formed in the ablation zone. One day after operation, 16 (55.2%) ablation zones formed gas-like low-density rings and were absorbed 3 months after surgery. The effective area of postoperative ablation area continued to shrink, postoperative CT value gradually decreased and no clear enhancement. The lesions of 4 PD groups showed an increase in area, an increase of CT value and enhancement, and no signs of low density and low density ring were found. Conclusions The area of ablation zone is gradually reduced, the CT value of CT scan continues to decrease and the CT value of enhanced CT scan increases by <15 HU. There is low density ring and cavity formation on the edge of ablation zone, which can help to judge the progression of lesions. It is of great value in reflecting its changes.