【摘要】 目的探讨肝脏恶性肿瘤精准放疗前磁粒子信标植入的可行性。方法 2019年4月至5月,江苏省肿瘤医院放疗科对2例肝脏恶性肿瘤患者在行肝脏病灶放射治疗前,在CT引导下行肝肿瘤旁磁粒子信标植入术。观察患者磁粒子信标植入效果及不良反应发生情况。结果 2例手术均成功完成,手术中磁粒子信标顺利植入肝实质内病灶旁预定靶点处。术中无明显出血,术后即刻CT扫描肝包膜下无出血,患者无明显疼痛等不适,术后无发热。术后第5天定位CT检查示仅1枚信标轻微移位,余信标无移位,CT图像无明显金属伪影。2例患者放疗结束后行肝脏30T MRI检查示信标处磁敏感伪影较明显,影响局部肝脏组织的观察。结论肝脏磁粒子信标植入术安全可行。信标植入后短期内在肝实质内有小范围移位的可能,故定位CT检查建议在信标植入4天后,待信标固定后再进行。信标植入后行CT扫描无明显金属伪影,后期随访建议首选CT检查,MRI检查磁敏感伪影较明显,会影响局部疗效评估及发现新小病灶。更多还原

【Abstract】 Objective To investigate the feasibility of magnetic particle beacon implantation before precise radiotherapy for liver malignant tumor.Methods Two patients with liver malignant tumor who underwent CT-guided magnetic particle beacon implantation before precision radiotherapy were selected. The outcomes of implantation and the occurrence of adverse reactions were recorded.Results Both operations were successfully completed. During the operations, the magnetic particle beacons were successfully implanted at the predetermined targets in the liver parenchyma. There was no significant bleeding during the operations. And the CT scans showed no significant bleeding under the liver capsule after the operations. The patients had no significant pain or discomfort. No fever occurred after operation. Only one beacon moved slightly on the 5th day after the operation showed by localized CT examination. And the CT images had no obvious metal artifacts. 3.0T MRI examination showed that the magnetic sensitive artifacts at the beacons were more obvious, which affected the observation of local liver tissue after radiotherapy.Conclusions Liver magnetic particle beacon implantation is safe and feasible. There may be a small range of movement within the liver parenchyma shortly after the beacon being implanted. Therefore, localized CT examination is recommended after the beacon being implanted for 4 days. There are no obvious metal artifacts on CT scan after beacon implantation which is recommended for follow-up. Besides, magnetic sensitivity artifacts are more obvious when MRI is performed,which affects the evaluation of local efficacy and the discovery of small lesions.更多还原