CAJ | 학술논문

目的探讨小肝癌射频消融术(RFA)前后影像学表现与肿瘤肝内复发的相关性.方法共纳入进行射频消融术的34例患者中的39个小肝癌病灶,对复发与无复发组病灶的磁共振成像(MRI)表现进行回顾性比较分析,同时根据复发病灶数,对单发及多发复发病例进行亚组分析.根据资料不同分别采用Kaplan-Meier法、t检验/Mann-WhitneyU检验、Fisher精确概率检验或方差分析.结果本研究的中位随访时间为25个月(4 ～ 45个月).34例患者中,19例(55.9％)在随访期间发生肝内复发,1年及2年累积无复发生存率分别为71.3％及51.8％.术前缺乏肿瘤包膜(P=0.017)、术后24h内无或非连续的环形强化(P=0.012)及较小的射频边界(P=0.037)更常见于复发组病例中;同时,肝内多发复发者术后24h内病灶平均表观弥散系数(1.57×10-3mm2/s)较单发者(1.34×10-3mm2/s)高(P=0.040).结论 RFA术前及术后早期MRI表现有助于为临床提供早期预测指标,监测肝癌肝内复发.
목적 탐토소간암사빈소융술(RFA)전후영상학표현여종류간내복발적상관성.방법 공납입진행사빈소융술적34례환자중적39개소간암병조,대복발여무복발조병조적자공진성상(MRI)표현진행회고성비교분석,동시근거복발병조수,대단발급다발복발병례진행아조분석.근거자료불동분별채용Kaplan-Meier법、t검험/Mann-WhitneyU검험、Fisher정학개솔검험혹방차분석.결과 본연구적중위수방시간위25개월(4 ～ 45개월).34례환자중,19례(55.9％)재수방기간발생간내복발,1년급2년루적무복발생존솔분별위71.3％급51.8％.술전결핍종류포막(P=0.017)、술후24h내무혹비련속적배형강화(P=0.012)급교소적사빈변계(P=0.037)경상견우복발조병례중;동시,간내다발복발자술후24h내병조평균표관미산계수(1.57×10-3mm2/s)교단발자(1.34×10-3mm2/s)고(P=0.040).결론 RFA술전급술후조기MRI표현유조우위림상제공조기예측지표,감측간암간내복발.
Objective To investigate the correlation between magnetic resonance imaging (MRI) characteristics and intrahepatic recurrence of small hepatocellular carcinoma (HCC) after radiofrequency ablation (RFA).Methods A total of 34 patients with 39 small HCC who underwent RFA were included in our study.MRI characteristics were compared between the recurrence group and the non-recurrence group; and a subgroup comparison was also made between the solitary recurrence group and the multiple recurrence group.Kaplan-Meier test,t-test/Mann-Whitney U test,Fisher's exact test and F-test were used for statistical analyses.Results The median follow-up period was 25 (4-45) months and recurrence was observed in 19 (55.9％) of the patients.The 12-and 24-month cumulative recurrence-free survival rates were 71.3％ and 51.8％,respectively.The recurrence group had a higher prevalence of lack of tumour capsule before RFA (P =0.017),no or disrupted periablational enhancement within 24 hours after RFA (P =0.012),and a smaller ablative margin (P=0.037).Meanwhile,the average apparent diffusion coefficient value within 24 hours after RFA was higher in the multiple recurrence group (1.57 × 10-3mm2/s) than in the solitary recurrence group (1.34 × 10-3 mm2/s) (P =0.04).Conclusion MRI can provide early noninvasive findings useful for advanced warning ofintrahepatic recurrence after RFA.