经皮微波治疗肝癌坏死范围的超声判断  

Ultrasonographic evaluation of coagulative necrotic area in patients with hepatocellular carcinoma during percutaneous sonographically guided microwave coagulation therapy

作　　者：何年安[1] 王文平[1] 季正标[1] 李超伦[1] 黄备建[1] 

机构地区：[1]复旦大学附属中山医院超声科,上海市200032

出　　处：《实用肝脏病杂志》2009年第5期362-365,共4页Journal of Practical Hepatology

基　　金：上海市重点学科建设项目资助[B112]

摘　　要：目的探讨在超声引导下经皮微波凝固(PMCT)术治疗肝癌过程中采用实时灰阶超声判断凝固坏死范围的价值。方法在PMCT术治疗19例HCC患者过程中,采用灰阶超声全程监测治疗灶强回声范围的最大短轴径(SDT)和最大长轴径(LDT)。在治疗后1小时和1个月后,再次行实时灰阶谐波超声造影测量凝固坏死灶对应的SDC和LDC。结果在18例治疗灶明显增强的患者,治疗时病灶表现出椭圆状强回声,其SDT与1小时后超声造影的SDC1的相关系数为0.64,LDT与LDC1的相关系数为0.73;SDT与一月后超声造影SDC2的相关系数为0.79;LDT与LDC2的相关系数为0.76。1例患者术中治疗灶强回声范围表现不明显,超声造影证实为完全坏死。结论在PMCT术中灰阶超声监测的病灶最大强回声范围与术后超声造影所测凝固坏死灶大小具有一定的相关性,可作为治疗时凝固坏死范围的参考;但因它们的相关系数并不高,且有个别病灶强回声表现不明显,故在PMCT术后还应采用多种监测手段综合判断其疗效。Objective To probe the role of real-time gray-scale US in the assessment of the necrosis in patients with hepatocellular carcinoma during percutaneous sonographically guided microwave coagulation therapy（PMCT）. Methods In 19 patients with HCC,the maximal long-axis diameter（LDT） and maximal short-diameter（SDT） of the strong echo in the lesions were measured by gray-scale US during PMCT. The corresponding diameters were measured at 1 hour and 1 month after PMCT on SonoVue-enhanced real-time harmonic grey-scale uhrasonography （SonoVue-ERHG US））. The resuits from the two methods were compared and analyzed. Results During PMCT,strong echoes in lesions appeared in 18 cases,and the correlation coefficients between SD7 and SD after 1 hour and 1 month were 0.64 and 0.79,respectively;the correlation coefficient between the LDT and the LD after 1 hour and 1 month were 0.73 and 0.76,respectively. Conclusions In a certain degree,the diameters of strong echoes in lesions during PMCT are correlated with the diameters measured using SonoVue-ERHG US after PMCT.

关 键 词：肝肿瘤 经皮微波凝固治疗 超声造影 

分 类 号：R735.7[医药卫生—肿瘤] R766.18[医药卫生—临床医学]