高强度聚焦超声消融胰腺癌安全性及疗效研究  

Ablation Effects of High-intensity Focused Ultrasound Therapy on Pancreatic Cancer

作　　者：汪伟[1] 唐杰[1] 叶慧义[2] 白玲[3] 周洁敏[3] 

机构地区：[1]解放军总医院超声科,北京市100853 [2]解放军总医院核磁室,北京市100853 [3]解放军307医院功检科

出　　处：《中国超声医学杂志》2007年第1期76-79,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的评估高强度聚焦超声(HIFU)消融胰腺肿瘤的安全性及疗效。方法应用JC型体外HIFU肿瘤治疗系统治疗不能手术切除的胰腺癌,通过治疗前后的增强影像评估肿瘤的消融体积,探讨其与超声治疗参数之间的关系。结果20例HIFU治疗的胰腺癌有16例获得治疗后的消融影像评估,肿瘤消融比率平均为(55.9±33.7)%,HIFU治疗的最大声功率与肿瘤消融比率呈正相关(r=0.686,P=0.020),高声功率治疗组(最大声功率≥300W)获得的肿瘤消融比率[(68.5±26.1)%]显著大于低声功率治疗组(最大声功率≤280W)获得的消融比率[(32.5±31.8)%,P<0.05]。15例治疗前显著疼痛的患者有12例治疗后疼痛缓解或显著减轻。本组1例高声功率HIFU治疗后发生了肠系膜上动脉闭塞。结论使用较高的声功率,体外HIFU治疗能够有效地消融胰腺肿瘤和缓解疼痛,作为晚期胰腺癌的减瘤治疗措施,其安全性和临床意义值得进一步研究。Objective To evaluate the safeties and ablation effects of extracorporeal high-intensity focused ultrasound （HIFU） therapy on pancreatic cancer. Methods Among the 20 unresectable pancreatic cancer patients who received HIFU ablation therapy （using JC-model HIFU tumor therapeutic system）, 16 patients got an enhanced imaging （MRI or CT） evaluation for coagulative necrosis. Results The calculated mean heated ablation ratio （necrosis volume/target tumor volume） was 55.9±33.7 %. The ablation ratio was correlated with the maximum radiated acoustic power （r=0. 686, P=0. 020）. The higher acoustic power group （maximum radiated acoustic power≥ 300W） got a significant higher ablation ratio than that of the lower acoustic power group （maximum radiated acoustic power ≤280W）, ie 68.5±26.1% vs. 32.5±31.8%, P≤0. 05. Twelve of the 15 patients who complained serious pain reflected marked relief after HIFU ablation. Secondary occlusion of superior mesenteric artery occurred in one patient who received the HIFU ablation with 440W maximum radiated acoustic power. Conclusions Using high radiated acoustic power, extracorporeal HIFU can effectively ablate pancreatic cancer. As a palliative therapy for advanced pancreatic cancer, the safeties and clinical significance should deserve to be proved with further research work.

关 键 词：高强度聚焦超声 胰腺肿瘤 热消融体积 声功率 

分 类 号：R735.9[医药卫生—肿瘤]