CAJ | 학술논문

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。
목적：관찰병분석간암사빈소융（RFA）치료후자공진수방신호적동태변화특정。방법회고성분석2009년1월지2010년12월80례행사빈소융치료적원발성간암환자적동태증강MRI자료，근거MRI수방시간분위삼조：사빈소융치료후1개월、3～6개월、6개월이후，비교간암 RFA치료후불동시간단적MRI표현급동태변화。결과80례간암환자공109개병조，RFA치료후1개월，재지방억제FLASH-T1WI상RFA구역전표현위고신호，수착시간연장，RFA구역중심신호정불동정도하강，6개월후RFA구역중심신호하강여1개월급3～6개월내신호상비，차이균유통계학의의（P＜0.05）；FSE-T2WI억지상상，RFA구역신호수시간연장축점정불균균성승고，1개월、3～6개월급6개월이후신호비교차이유통계학의의（P＜0.05）。증강후조기RFA구역주요표현위변연선양강화，반혹불반이상관주，사빈소융완전적병조，수착시간연장칙변연추향무강화；국부잔류5개、국부진전17개，MRI상표현위변연불청，반소결절상이상강화。결론원발성간암RFA치료후，동태증강MRI시현시종류완전배사、잔류혹국부진전적유효검사수단。
Objective To observe and analyze in the signal changes of dynamic enhanced MRI for hepatocellular carcinoma after radiofrequency ablation during follow-up studies. Methods From January 2009 to December 2010, MRI images of 80 patients with 109 hepatocellular carcinoma treated with RFA were analyzed retrospectively, which were categorized into 3 examination intervals(about 1 m, 3-6 m,>6 m). The sequential changes of I images were assessed and compared. Results All the RFA areas exhibited hyper-intensity on FLASH-T1WI with fat suppression within 1 month after ablation. Subsequently, the signal intensities of the RFA areas decreased on T1WI.On T1WI with fat suppression, RFA lesions showed significant differences after 6 months(P<0.015). On FSE-T2WI with fat suppression, RFA lesions showed significant differences between different time intervals (P<0.015). On contrast-enhanced MR images, RFA lesions showed peripheral rim of enhancement within 1 month and exhibited a tendency to show no enhancement(n=87 at 3-6 months and n=21 after 6 months), with significant differences between MR examination intervals(P<0.015). In 5 patients with residual tumor and 17 with local tumor progression, nodular lesions were found at the periphery of the ablated areas. These nodular lesions showed moderate to marked enhancement. Conclusion MR imaging is an effective method, which could depict the characteristics of coagulative necrosis of tumor, residual tumor or local tumor progression in patients with hepatocellular carcinoma after RFA therapy.