高强度聚焦超声治疗门静脉癌栓40例  

High-intensity focused ultrasound for treatment of portal vein tumor thrombosis:40 cases report

作　　者：党亚正[1] 扬洁[2] 费晋秀[1] 齐涛[1] 蔡永胜[1] 白瑞佳[1] 陆婉玲[1] 

机构地区：[1]解放军第323医院肿瘤中心,陕西西安710054 [2]解放军第1医院,甘肃兰州730050

出　　处：《第四军医大学学报》2008年第22期2092-2094,共3页Journal of the Fourth Military Medical University

摘　　要：目的:探讨高强度聚焦超声(HIFU)治疗门静脉癌栓的有效性及临床应用价值.方法:对40例晚期肝癌合并PVTT患者的51支门静脉主干或(和)第1级分支内癌栓进行HIFU治疗,观察治疗后癌栓支门静脉血流变化、癌栓回声和消减变化以及患者肝功能、腹水和生活质量改善情况.结果:治疗前11例15支门静脉充满型癌栓支彩色多普勒超声无血流信号,癌栓呈低回声或等回声;治疗3～4次后,13支PVTT由低回声或等回声变为中等回声或强回声,癌栓体积较前缩小1/2～1/3,门静脉内见到彩色血流信号;第5～7次治疗后,15支PVTT支均见彩色血流信号,癌栓体积进一步缩小,其中13支见到连续稳定的再通血流信号,患者肝功能、腹水和生活质量均有不同程度的改善.29例36支非充满型PVTT经治疗后,癌栓回声明显增强,其体积缩小1/2～1/5,原来连续不稳定的血流信号变为稳定的再通血流信号.结论:HIFU治疗PVTT安全、痛苦小、无创伤、有肯定的疗效,将成为一种用于治疗大多数PVTT的新方法.AIM： To evaluate the efficacy and clinical value of high-intensity focused ultrasound（HIFU） for the treatment of portal vein tumor thrombus （PVTT） in patients with hepatocellular carcinoma. METHODS： Forty patients with advanced hepatocellular carcinoma including 51 PVTT portal veins and main branches, were treated with HIFU, and the changes in the blood flow of PVTT embolized portal vein, the echo and the size of tumor thrombi, the function of liver, the ascites and the life quality were observed. RESULTS： Before treatment, there was no blood flow signal, with low echo and equivalent echo on color Duppler ultrasonography in 15 PVTT embolized portal veins of 11 patients. After 3 or 4 times treatment, the low echo and equivalent echo became moderate or strong echo; the volume of PVTT were reduced by 1/2-1/3, and color flow signals were seen in 13 portal vein. After 5-7 times treatment, the echo of blood flow in 15 portal veins was significantly enhanced and the volume of PVTT was reduced, and the signal of blood flow in 13 portal veins became continuous and stable signal indicating repatency. The improvements of liver function, ascites and life quality to varying degrees were observed. After treatment, the echo of blood flow in 36 portal veins of 29 patients was significantly enhanced and the volume of PVTT was reduced by 1/2-1/5, and the signal of blood flow changed from unstable to stable, indicating repatency. CONCLUSION： HIFU may be a safe, less painful, noninvasive and effective new method in the treatment of patients with PVTT.

关 键 词：癌 肝细胞 门静脉癌栓 超声疗法 

分 类 号：R735.7[医药卫生—肿瘤]