超声造影在肝癌射频消融治疗中的临床价值  

Clinical Value of Contrast Enhanced Ultrasound in Treatment of Liver Cancer with Radiofrequency Ablation

作　　者：经翔[1] 丁建民[1] 王彦冬[1] 刘艳丽[1] 高磊[1] 王毅军[1] 杜智[1] 

机构地区：[1]天津市第三中心医院超声科,天津市300170

出　　处：《中国超声医学杂志》2010年第8期734-737,共4页Chinese Journal of Ultrasound in Medicine

基　　金：天津市卫生局科技基金资助(No.06KZ16)

摘　　要：目的探讨超声造影(CEUS)在肝癌射频消融(RFA)治疗中的临床价值。方法 91例肝癌患者在RFA治疗前后接受了CEUS检查,分别对CEUS在RFA治疗前、治疗过程中、治疗后的作用进行评价。以3个月以上的影像学检查及肿瘤标志物随访或穿刺活检的病理结果作为最终诊断。结果 RFA前:91例114枚肝癌病灶中109(95.6%)枚CEUS可清晰显示边界;CEUS测量病灶平均最大直径、面积与常规超声比较,差异有统计学意义(P<0.05);CEUS对荷瘤血管的检出率为61.4%。RFA过程中:1枚常规超声未能显示的病灶在CEUS引导下完成RFA治疗;4枚病灶RFA后即刻CEUS发现残留,CEUS引导下完成补充治疗。RFA后:88例获得随访,其中49例接受了同期的CECT,CEUS和CECT评价RFA治疗后病灶残留复发的敏感性、特异性、准确性比较,差异无统计学意义(P>0.05)。结论 CEUS在肝癌RFA治疗前、治疗过程中和治疗后均具有重要的临床价值。Objective To explore the clinical value of contrast enhanced ultrasound （CEUS）in treatment of liver cancer with radiofrequency ablation （RFA）. Methods 91 patients with 114 lesions underwent CEUS before and after RFA and the usefulness of CEUS was evaluated before, during and after RFA, respectively. The final diagnosis was achieved by more than 3 months＇ follow-up of imaging examinations and tumor marker or biopsy. Results Before RFA： the boundary of 95.6% （109/114）lesions could be demarcated on CEUS. The size of the lesions measured was larger on CEUS than on conventional ultrasound （P〈0.05）. Bearing cancer blood vessels were detected with CEUS in 61.4% （70/l14）lesions. During RFA..One HCC patient with one lesion which could not be displayed on conventional ultrasound was treated with RFA by CEUS guidance. Residual viable tumors were visible on immediate CEUS after RFA in 4 patients with 4 lesions, and additional treatment with RFA was accomplished by CEUS guidance. After RFA： 88 among all patients were followed up,and 49 of the 88 patients underwent CECT at the same time. There was no significant difference in sensitivity, specificity and accuracy in evaluating therapeutic effect between CEUS and CECT. Conclusions CEUS is use.ful and effective, before,during and after RFA. Its clinical value is significant.

关 键 词：超声检查 造影剂 射频消融 肝癌 

分 类 号：R735.7[医药卫生—肿瘤] R445.1[医药卫生—临床医学]