超声造影在肝癌射频消融治疗中的作用  

Effect of contrast-enhanced ultrasound radiography to the radiofrequency ablation of liver cancer treatment

作　　者：张令海[1] 袁庆忠[2] 纪永利[1] 卜庆敖[2] 崔涛[2] 徐付印[1] 

机构地区：[1]胜利油田中心医院超声科,山东东营257034 [2]胜利油田中心医院肝胆外科,山东东营257034

出　　处：《中国现代普通外科进展》2011年第1期38-41,共4页Chinese Journal of Current Advances in General Surgery

摘　　要：目的：探讨超声造影（CEUS）在肝癌冷循环射频消融（RFA）治疗中的应用价值。方法：选取肝癌患者20例25个病灶为观察对象,RFA治疗前行CEUS确定肿瘤的性质、数目和大小,治疗后1个月内和随访10个月后行CEUS与增强CT对比疗效评价。结果：治疗后1个月内CEUS复查,20个消融病灶各期均无异常增强区,提示肿瘤完全灭活;4个边缘局部有早期增强,提示肿瘤残留,增强区经增强CT及穿刺活组织检查证实为肿瘤残留,当即补充RFA治疗;1个CEUS图像模糊,未能作出诊断。随访10个月,1个消融病灶有残留复发,4例患者行CEUS发现新生病灶11个,直径0.6-3.8 cm,其中2例4个直径〈1.0 cm的病灶增强CT未能发现。结论：CEUS可以在RFA治疗前为治疗方案提供依据,在治疗后判断RFA疗效,是一种有效方法,并有助于发现微小新病灶。Objective： To understand the value of contrast-enhanced ultrasound radiography（CEUS） to the radiofrequency ablation（RFA）of liver cancer treatment.Methods： Select 25 lesions of 20 patients with liver cancer,do CEUS to define the nature,the number and size of the tumor before RFA,to evaluate the efficacy with CEUS within 1 and 10 months after treatment,and compare the results with enhanced CT.Results： Do CEUS within 1 month after treatment,no abnormal enhanced areas were found in all phases of 20 ablation lesions,which showed that tumor were completely inactivated,Early enhancement were locally found on the edges of 4 cases,which means residual tumor,enhanced CT and biopsy of enhanced areas confirmed residual tumor,RFA treatment were offered immediately,One case had blurring image,which fail to diagnose.During the10-month follow-up,1 case had residual recurrence,4 cases had 11 new lesions under CEUS,0.6~3.8 cm in diameter,4 lesions with a diameter less than 1.0 cm in 2 cases were not found under enhanced CT.Conclusion： CEUS is an effective method,which can provide the basis for the treatment before RFA,determine the efficacy after RFA,and can help to identify new small lesion.

关 键 词：肝肿瘤 超声造影 射频消融 

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