Thermoablative Treatments for Malignant Liver Lesions: 10-Year Experience of MRI Appearances of Treatment Response
Thermoablative Treatments for Malignant Liver Lesions: 10-Year Experience of MRI Appearances of Treatment Response
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DOI：
10.2214/ajr.09.2621
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发表时间：
2010-02-01
影响因子：
5
通讯作者：
Semelka, Richard C.
中科院分区：
文献类型：
--
作者：
Kierans, Andrea S.;Elazzazi, Mohamed;Semelka, Richard C.
OBJECTIVE.我们研究的目的是描述我们10年的经验，使用MRI来评价对恶性肝脏病变治疗中局部热消融干预的反应。这项回顾性研究从1998年到2008年进行。在射频消融（RFA）、冷冻消融和微波消融后< 4、4-9和> 9个月进行1.5和3 T MRI研究。根据平扫T1加权像上的信号强度和增强图像上边界不清的病灶周围增强、边界清楚的病灶增强或洗脱来评价MR特征。影像学特征进行了评价与所有介入方式一起和单独。研究人群由135名男性和36名女性（203处消融病变）组成，平均年龄为65岁（范围：39-78岁）。当合并所有治疗方法的数据时，无论随访时间类别如何，明确的病灶增强和洗脱是消退和未消退结局组的显著结果。射频消融后，消融区域在T1图像上倾向于显示高信号强度，而冷冻消融后可见低信号，微波消融后可见高信号边缘。仅在冷冻消融后9个月描述了洗脱，但在RFA后4个月内12%的病变中观察到洗脱。三种方法联合或单独使用对病灶周围强化不清的影响无显著性差异。消融后的MRI结果取决于治疗方式以及手术和随访检查之间的时间长度。
OBJECTIVE. The objective of our study was to describe our 10-year experience using MRI to evaluate response to local thermoablative interventions in the treatment of malignant liver lesions.MATERIALS AND METHODS. This retrospective study was conducted from 1998 to 2008. MRI studies were performed at 1.5 and 3 T and were acquired < 4, 4-9, and > 9 months after radiofrequency ablation (RFA), cryoablation, and microwave ablation. MR features were evaluated on the basis of signal intensity on unenhanced T1-weighted images and the presence of ill-defined perilesional enhancement, well-defined lesional enhancement, or washout on contrast-enhanced images. Imaging features were evaluated with all interventional modalities together and separately.RESULTS. The study population was composed of 135 men and 36 women (203 ablated lesions) with a mean age of 65 years (range, 39-78 years). When the data for all treatment methods were combined, well-defined lesional enhancement and washout were significant findings among the resolved and unresolved outcome groups regardless of follow-up time category. After RFA, ablated areas had a tendency to show high signal intensity on T1 images, whereas low signal was seen after cryoablation and a hyperintense rim was seen after microwave ablation. Washout was only depicted 9 months after cryoablation but was seen in 12% of lesions < 4 months after RFA. No difference was appreciated on ill-defined perilesional enhancement with all methods combined or separately.CONCLUSION. MRI findings after ablation are dependent on the treatment modality and the length of time between the procedure and follow-up examination.