张云嵩, 蔡迎玖, 陈田子, 董建林, 高小俊, 张彦伟, 白芳. CT多平面重建技术在肺癌氩氦冷冻消融治疗中的价值[J]. 中国肿瘤临床, 2018, 45(4): 185-190. DOI: 10.3969/j.issn.1000-8179.2018.04.207
引用本文: 张云嵩, 蔡迎玖, 陈田子, 董建林, 高小俊, 张彦伟, 白芳. CT多平面重建技术在肺癌氩氦冷冻消融治疗中的价值[J]. 中国肿瘤临床, 2018, 45(4): 185-190. DOI: 10.3969/j.issn.1000-8179.2018.04.207
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Zhang Yunsong, Cai Yingjiu, Chen Tianzi, Dong Jianlin, Gao Xiaojun, Zhang Yanwei, Bai Fang. The value of computed tomography multi-planner reconstruction in the treatment of lung cancer with percutaneous argon-helium cryoablation[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2018, 45(4): 185-190. DOI: 10.3969/j.issn.1000-8179.2018.04.207
Citation: Zhang Yunsong, Cai Yingjiu, Chen Tianzi, Dong Jianlin, Gao Xiaojun, Zhang Yanwei, Bai Fang. The value of computed tomography multi-planner reconstruction in the treatment of lung cancer with percutaneous argon-helium cryoablation[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2018, 45(4): 185-190. DOI: 10.3969/j.issn.1000-8179.2018.04.207
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CT多平面重建技术在肺癌氩氦冷冻消融治疗中的价值

The value of computed tomography multi-planner reconstruction in the treatment of lung cancer with percutaneous argon-helium cryoablation

    摘要
  • 摘要:
      目的  探讨CT多平面重建技术（multi-planner reconstruction，MPR）在肺癌经皮穿刺氩氦冷冻消融治疗中的应用价值。
      方法  选取2013年1月至2016年1月在天津中医药大学附属武清中医院接受常规轴位扫描或MPR引导下实施经皮穿刺氩氦冷冻消融治疗，有完整随访资料的T2或T3期非小细胞肺癌患者66例。按引导方式分为常规组31例，MPR组35例。比较相同布针数量时两组穿刺次数、穿刺误差、操作总时间以及并发症发生率、肿瘤残留率、局部控制率差异。
      结果  相同布针数量时，两组术中平均穿刺次数、穿刺误差比较，MPR组均显著低于常规组（P < 0.05）；平均操作时间比较，MPR组与常规扫描组差异无统计学意义（P>0.05）。术后相关并发症发生率MPR组均显著低于常规扫描组，其中穿刺合并出血为1.52% vs. 13.64%、穿刺继发气胸为3.03% vs. 19.70%，（P < 0.05），组间比较差异均具有统计学意义。随访至术后12个月时，MPR组的肿瘤局部残留率、总有效率等治疗获益指标均显著优于常规组，分别为1.52%vs. 10.61%和51.52%vs. 36.36%，（P < 0.05）。
      结论  MPR技术引导经皮穿刺肺癌氩氦冷冻消融治疗穿刺误差小、并发症发生率低、治疗获益显著，值得在临床推广。

     

    Abstract:
      Objective  To evaluate the value of computed tomography (CT) multi-planner reconstruction (MPR) in the treatment of lung cancer with percutaneous argon-helium cryoablation.
      Method  A total of 66 patients with stage T2 or T3 non-small cell lung cancer who had complete follow-up data were treated with percutaneous argon-helium cryoablation with conventional axial CT (conventional group) or MPR guidance (MPR group) between January 2013 and 2016. There were 31 patients in the conventional group and 35 in the MPR group. The total number of punctures, the total time of operation, and the incidence of complications, tumor residual rates, and local control rates were compared between the two groups.
      Results  When the number of needles was the same, the average number of punctures and puncture errors in the two groups were significantly lower in the MPR group than in the conventional group (P < 0.05). Comparing the average operation time, there was no statistical difference between the MPR group and the conventional scan group (P>0.05). The incidence of postoperative complications was significantly lower in the MPR group than in the conventional scan group. Among them, the incidence of puncture combined hemorrhage was 1.52% vs. 13.64%, and pneumothorax secondary to puncture was 3.03% vs. 19.70% (P < 0.05). During the follow-up period to 12 months after surgery, the therapeutic benefit indicators such as local residual rate and total effective rate in the MPR group were also significantly better than those in the conventional group, which were 1.52% vs. 10.61 and 51.52% vs. 36.36% (P < 0.05), respectively.
      Conclusions  Using MPR technology to guide percutaneous argon-helium cryoablation treatment for lung cancer confers a small puncture error, low incidence of complications, and significant treatment benefits. This method is worthy of clinical promotion.

     

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