CAJ | 학술논문

目的探讨实时超声造影技术在肾肿瘤腹腔镜下射频消融术(laparoscopic radiofrequency ablation,LRFA)中监测的应用价值. 方法 2008年3月至2011年8月诊断符合肾肿瘤行LRFA的患者61例,随机分为2组.常规组31例,术中使用二维超声评判消融效果；超声造影组30例,术中使用超声造影判断消融效果.术后1、3、6个月及其后每6个月常规复查增强CT,评判LRFA术后肿瘤残留和复发情况. 结果超声造影组31个病灶中有2个使用常规方法评判认为无肿瘤残留,实时超声造影显示有肿瘤残留行再次消融.术后1个月增强CT检查显示,超声造影组31个病灶完全消融(100％),而常规组32个病灶完全消融31个(97％).中位随访时间16个月中,超声造影组未发现肿瘤残留或者复发,常规组发现肿瘤残留1例、肿瘤复发1例,两组局部肿瘤控制率分别为100％ (30/30)及94％(29/31). 结论超声造影可以用于LRFA术中实时监测,有望提高肾肿瘤的完全消融率和局部肿瘤控制率.
목적 탐토실시초성조영기술재신종류복강경하사빈소융술(laparoscopic radiofrequency ablation,LRFA)중감측적응용개치. 방법 2008년3월지2011년8월진단부합신종류행LRFA적환자61례,수궤분위2조.상규조31례,술중사용이유초성평판소융효과；초성조영조30례,술중사용초성조영판단소융효과.술후1、3、6개월급기후매6개월상규복사증강CT,평판LRFA술후종류잔류화복발정황. 결과 초성조영조31개병조중유2개사용상규방법평판인위무종류잔류,실시초성조영현시유종류잔류행재차소융.술후1개월증강CT검사현시,초성조영조31개병조완전소융(100％),이상규조32개병조완전소융31개(97％).중위수방시간16개월중,초성조영조미발현종류잔류혹자복발,상규조발현종류잔류1례、종류복발1례,량조국부종류공제솔분별위100％ (30/30)급94％(29/31). 결론 초성조영가이용우LRFA술중실시감측,유망제고신종류적완전소융솔화국부종류공제솔.
Objective To evaluate the value of real-time contrast-enhanced ultrasonography (CEUS) in determining the endpoint of laparoscopic radiofrequency ablation (LRFA) in the treatment of renal lesions and its clinical outcome.Methods From Mar.2008 to Aug.2011,61 consecutive renal tumor patients meeting inclusion criteria were recruited and randomized to a pilot,open label,randomized study.There were CEUS group (LRFA performed under the real time CEUS monitoring) and conventional group (LRFA performed under a combination of ultrasound and laparoscopic monitoring).Contrasted CT was performed 1,3,6 months postoperatively and every six months thereafter in both groups to evaluate the ablation efficacy and recurrence rates.Results Two tumors (2/31,6％) needed additional ablation after second CEUS during the procedure in CEUS group.On the one-month post-RFA CT imaging,31 of 31 tumors (100％) and 31 of 32 tumors (97％) were successfully ablated in CEUS group and conventional group respectively.Within median 16 months follow-up period,one incomplete ablation and one local recurrence were found in conventional group while none in CEUS group.The local tumor control rate was 94％ (29/31) in conventional group versus 100％ (30/30) in CEUS group,P =0.492.Conclusions CEUS seems to be a useful imaging technique in monitoring LRFA in the treatment of renal tumors.This novel imaging modality may allow more effective renal tumor ablation and thus increase local tumor control rate.