目的

探讨CT引导下肺部恶性肿瘤射频消融（RFA）治疗的临床应用价值以及近期治疗效果。

方法

32例经病理证实的肺部肿瘤患者，包括原发性肺癌28例（28个病灶）、转移瘤4例（10个病灶），均在CT引导下行RFA治疗，术后1、3个月增强CT扫描观察近期疗效。

结果

38个病灶RFA治疗后10 min内CT复查示病灶阴影增大，CT值降低；术后1个月增强CT复查可见肿瘤去血管化表现，仅在病灶边缘强化及肿瘤残留区域强化。38个病灶治疗后3个月增强CT复查，无肿瘤完全消失（CR）者，肿瘤缩小者（PR）占76.32%（29/38），肿瘤无变化者（SD）占10.53%（4/38），肿瘤增大者（PD）占13.16%（5/38），11例残留病灶后期进行经皮无水乙醇化学消融。无严重并发症发生。

结论

CT引导肺部恶性肿瘤射频消融是一种安全有效的微创治疗方法，近期疗效明显。

Objective

To evaluate the value of CT-guided percutaneous radiofrequency ablation（RFA）therapy of lung tumours.

Methods

Thirty-two patients with pathologically proved lung neoplasms that comprised 28 primary lung cancers（total 28 lesions），4 metastases（total 10 lesions）initially underwent CT-guided percutaneous RFA treatment and subsequently the near-term efficacy.

Results

Our experiences have indicated an initial increase in lesion size at immediate follow-up CT.The density of 38 lesions was lowered.Among total 38 lesions of 32 patients，RFA resulted in necrosis of 38 lesions，which appears as devascularization and enhancement of residual tumors on postcontrast CT images.Measurement of the lestns were rediologrcally assessed on axial CT scan in the lung window setting，with the regult of no lenins had complete response，partial response 76.32%（29/38），lesions stable disease 10.53%（4/38），lesions showed progressive disease13.16%（5/38）at 3 month follow-up CT.No severe complications related to the procedure occurred in the group patients.

Conclusions

CT-guided percutaneous RFA in treating lung neoplasms is safe and effective，which has recently received wide attention for the promising results achieved，and can serve as a new approach to the treatment of lung neoplasm.