实时超声造影在肝癌介入术中的应用价值  

Clinical value of contrast enhanced ultrasonography in the interventional treatment of liver cancer

作　　者：李敬东[1] 刘健[2] 赵兴友[2] 袁顺娴[2] 张宁[2] 

机构地区：[1]川北医学院附属医院肝胆外科,南充637000 [2]川北医学院附属医院超声科,南充637000

出　　处：《临床外科杂志》2010年第9期594-596,共3页Journal of Clinical Surgery

摘　　要：目的 探讨实时超声造影在肝癌微创介入治疗中的应用价值.方法 63例肝癌患者在分别接受经肝动脉化疗栓塞术（TACE）、射频消融（RFA）和微波消融（MCT）治疗中及治疗后,采用实时超声造影对其中76个病灶检查,并与常规超声、CT、数字剪影血管造影（DSA）比较.结果 TACE组21个病灶治疗后1个月, 超声造影显示13个病灶有部分残留,与DSA结果 一致.RFA组和联合治疗组（TACE和RFA,TACE和MCT）共55个病灶在首次接受RFA及MCT治疗后即刻行彩色多普勒超声（CDFI）检查,检出6个病灶部分残留,而超声造影检出24个病灶部分残留.介入治疗后最后一次随访中,超声造影显示有20个病灶部分残留、55个病灶治疗完全、1个病灶判断不明确,与最终诊断比较,在诊断准确性上,超声造影明显优于CDFI（P=0.039）,超声造影与增强CT比较,差异无统计学意义（P=0.930）.结论 实时超声造影可以增加检测肝癌的血流信号强度,有助于确定介入治疗范围,尤其对于在介入治疗短期内需多次确定疗效者以及消融治疗中即刻评价疗效者,更具优势.Objective To investigate the clinical value of contrast enhanced ultrasonography （CEUS）in the interventional treatment of liver cancer. Methods A total of 63 patients with liver cancer received different types of minimally invasive interventional therapy, including transcatheter hepatic arterial chemoembolization （ TACE ）, radiofrequency ablation （ RFA ） and microwave ablation （ microwave coagulation therapy,MCT）. During and after the treatment, 76 lesions were examined by CEUS, and the results were compared with those of conventional ultrasound, CT, digital subtraction angiography （DSA）. Results In the TACE group, CEUS showed 13 residue lesions among the 21 lesions one month after the first interventional treatment and the result was consistent with the DSA＇s result. In the RFA group and the combined treatment group（combined TACE with RFA or MCT）,55 lesions were examined immediately after the treatment and the results showed that 6 lesions were found residual with color Doppler ultrasound（CDFI） , while the CEUS found that there were 24 residual lesions after a second RFA or MCT treatment. In the last followup after the interventional therapy, CEUS examination revealed that 20 lesions were residual in part,55 lesions were cured, and a lesion was to determine. Sensitivity of CDFI, CEUS and enhanced CT in the detection of residual lesions was 28.6% （6/21） ,95.2% （20/21） ,90.5% （ 19/21 ） , respectively and the accuracy rates were 68.4% （52/76） ,98.7% （75/76） ,96.1% （73/76） ,respectively. In terms of ae- euracy,CEUS is much higher than CDFI（P =0. 039,P 〈0.05）. No significant difference was found in the accuracy rate between CEUS and enhanced CT（P = 0. 930, P 〉 0.05 ）. Conclusion CEUS can help determine the scope of interventional therapy by improving the detection of flow signals within the tumor, especially for the intervention to determine efficacy of repeated treatment in the short - term. It also possesses advantages in the immediate assessment of

关 键 词：肝癌 超声造影 介入治疗 

分 类 号：R735.7[医药卫生—肿瘤]