Practical Journal of Organ Transplantation(Electronic Version) ›› 2020, Vol. 8 ›› Issue (5): 349-352.DOI: 10.3969/j.issn.2095-5332.2020.05.005

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Efficacy and imaging changes of microwave ablation on pulmonary oligometastasis for liver transplant recipients

Ge Xihong 1 ,Liu Xiang 2 ,Cai Jinzhen 3 ,Wangjian 4 ,Guo Qingjun 3 ,Liu Yang 1 ,Shen Wen 1 .   

  1. 1. Department of Radiology, Tianjin First Central Hospital,Tianjin 300192,China ; 2. Department of Thoracic Surgery,Tianjin First Central Hospital, Tianjin 300192,China ; 3. Department of Liver Transplantation,Tianjin First Central Hospital,Tianjin 300192,China ; 4. Department of Hepatobiliary Surgery,Tianjin First Central Hospital,Tianjin 300192,China
  • Online:2020-09-20 Published:2021-06-02

肝癌肝移植术后肺寡转移瘤的微波消融治疗效果分析

葛夕洪 1 ,刘祥 2 ,蔡金贞 3 ,王建 4 ,郭庆军 3 ,刘洋 1 ,沈文 1
  

  1. 1. 天津市第一中心医院放射科, 天津 300192 ; 2. 天津市第一中心医院胸外科,天津 300192 ; 3. 天津市第一中心医院 肝移植科,天津 300192 ; 4. 天津市第一中心医院肝胆外科,天津 300192

Abstract:

Objective To investigate the effect of microwave ablation on pulmonary oligometastasis of liver transplant recipients without hepatic carcinoma. To observe the imaging changes after ablation. Methods A total number of 14 patients with 15 lesions were analyzed retrospectively. The ablation effect,complication and progression-free survival(PFS)were calculated. A total number of 15 lesions were divided into two groups,one group used the energy of 40 watt for 5 minutes,another group used the energy of 60 watt for 3 minutes . The short diameter and long diameter of ablation area were compared. The patient received follow up regularly. Results All the lesions were ablated by one procedure. The ablation area displayed“target sign”on CT image at first,then the lesion decreased in size during follow up,only fibrous scar can be observed at last. Different energy of 60 watt for 3 minutes and 40 watt for 5 minutes can get the same ablation effect. After ablation,the size of the short diameter and long diameter increased significant. The complication of pneumothorax was high(up to 71.4%)and 60% needed drainage. Incidence of bleeding of puncture tunnel and pain were 21.4%、28.6% respectively. Progression-free survival(PFS)was 7.4 months. Conclusion Microwave ablation can control pulmonary metastasis with acceptable complication. The ablation area displaied“target sign”on CT image.

Key words: Pulmonary oligometastasis , Liver transplantation , Microwave ablation , Computed tomography

摘要:

目的 观察微波消融对肝癌肝移植术后肝脏无瘤患者肺寡转移瘤的控制效果及影像动态变 化。方法 回顾性分析肝癌肝移植术后肝脏无瘤患者 14 例 15 个肺寡转移瘤微波消融后的局部控制效果、 并发症及随访资料。15 个转移瘤分成两组,分别为 40 W 消融 5 min 组和 60 W 消融 3 min 组,测量消融区 的长径及短径。观察消融后 12 h、1 ~ 3 个月、6 个月及长期的 CT 变化。结果 所有病例均一次消融成功, 消融区表现为“靶征”,后逐渐减小,仅残留少量索条。40 W 消融 5 min 和 60 W 消融 3 min 可达到相同的 消融效果。消融区长径、短径均比以前增大(P < 0.05)。气胸比例较高达 71.4%,其中 60% 需要引流。针 道出血及疼痛占比分别为 21.4%、28.6%。无进展生存期为 7.4 个月。结论 微波消融治疗肺寡转移瘤局部 控制效果良好,并发症可以接受。消融后的 CT 表现为靶征。

关键词: 肺寡转移瘤 , 肝移植 , 微波消融 , 计算机断层扫描