超声对无水乙醇治疗肝细胞癌早期疗效的评价  

Assessment of early-term effects of percutaneous ethanol injection by ultrasonography examination of hepatocellular carcinoma

作　　者：侯秀娟[1] 王洪波[1] 王虹[1] 王晓蕾[1] 刘爱武[1] 

机构地区：[1]哈尔滨医科大学附属第二医院超声科,黑龙江省哈尔滨市150086

出　　处：《世界华人消化杂志》2007年第24期2643-2647,共5页World Chinese Journal of Digestology

摘　　要：目的:探讨二维及彩色多普勒超声评价无水乙醇治疗肝细胞癌早期疗效的,临床应用价值.方法:经皮无水乙醇瘤内注射(PEI)治疗137例肝细胞癌患者(156个肿块,肿块直径1.4-5.0 cm),于PEI疗程结束后1wk,采用二维声像图(2D)、彩色多普勒血流显像(CDFI)、彩色多普勒能量图(CDE)检查技术,以2D的特定改变、CDFI及CDE血流信号显示的有无作为评价PEI早期疗效的观察指标,并行组织学活检病理检查.结果:以病理检查结果为金标准,2D,CDFI,CDE评价PEI治疗后肿瘤的灭活情况,其敏感性分别为:33.3%,50.0%,77.8%,准确性分别为:71.2%,78.8%,90.4%,Kappa值分别为:0.278(P<0.05),0.486(P<0.01),0.779(P<0.01).结论:2D,CDFI,CDE动态监控PEI治疗过程对指导治疗意义重大,CDFI,CDE评价PEI早期疗效结果客观可靠,CDE可以敏感而直观的显示PEI治疗后肿瘤周边及内部残存的血流信号,对指导PEI治疗时机及靶目标的选择以提高疗效具有重要的临床应用价值.AIM： To determine the clinical value of evaluating the early-term therapeutic effects of percutaneous ethanol injection （PEI） for hepatocellular carcinoma （HCC） by two-dimensional （2D） and color Doppler ultrasonography. METHODS： One hundred and thirty-seven patients with HCC （156 foci, 1.4-5.0 cm in diameter） received PEI. One week after the period of treatment, significant changes on 2D ultrasonography, and the disappearance or exact blood flow signals on color doppler flow imaging （CDFI） and color doppler energy （CDE） were observed. Heavy needle histological biopsies were also performed for pathological diagnosis. RESULTS： Compared to the gold standard of pathological results, the sensitivity for evaluat- ing foci of complete necrosis on 2D ultrasonog- raphy, CDFI and CDE were 33.3%, 50.0%, and 77.8%, respectively; accuracy was 71.2%, 78.8%, and 90.4%, respectively; while kappa values were 0.278 （P 〈 0.05）, 0.486 （P 〈 0.01） and 0.779 （P 〈 0.01）, respectively. CONCLUSION： Dynamic monitoring of PEI is important for 2D ultrasonography, CDFI and CDE. CDFI and CDE show promise for evaluating the early-term therapeutic effects of PEI. CDE sensitively demonstrate residual blood flow signals in peritumoral and intratumoral regions after PEI, and thus have clinical value for selecting therapeutic opportunities and target areas for improving the therapeutic effects of PEI.

关 键 词：二维及彩色多普勒超声 无水乙醇 介入治疗 肝细胞癌 早期疗效 

分 类 号：R735.7[医药卫生—肿瘤]