냉동수술을 시행한 신장세포암종의 전산화단층촬영과 자기공명영상에서 보이는 잔여 조영증강에 대한 추적검사

초록

Purpose: To describe the characteristics of residual contrast enhancement (CE) in cryoablated renal cell carcinoma (RCC) with regard to eventual resolution and the presence of residual tumor on follow-up CT and MRI. Materials and Methods: 22 patients with 24 RCCs underwent laparoscopic renal cryoablation and follow-up CT (n = 19) and MRI (n = 3) for a mean of 28 months. Two radiologists retrospectively assessed the CT and MRI images for the tumor size and characteristics of residual CE in the cryolesions: peripheral rim (< 10% of the maximum cryolesion diameter), focal eccentric (10-25%), and thick internal enhancement (> 25%). Results: Residual CE was seen in 13 cryolesions (54%) at 3-month follow-up. Peripheral rim and focal eccentric enhancement was seen in six (25%) and four (16.7%) cryolesions, persisted for a mean follow-up of 4.5 and 6 months, and disappeared completely at a mean follow-up of 10.5 and 12 months, respectively. Three (12.5%) cryolesions showed persistent thick internal enhancement at 6-month follow-up, and were treated with radiofrequency ablation or chemotherapy. The cryolesions had decreased in size by an average of 20.2% and 39.7% at 6 and 12 months after cryoablation, respectively. Conclusion: Follow-up for ≥ 12 months is needed to assess treatment outcomes in patients with peripheral rim or focal eccentric enhancement of cryoablated RCCs, which may persist until 12 months postoperatively without remnant viable tumor.

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