超声造影引导射频消融治疗等回声肝癌的临床应用  

The clinical application of contrast-enhanced ultrasound-guided radiofrequency ablation in treating iso-echo liver cancer

作　　者：翁高龙[1] 黄建国[1] 褚丹[1] 梅丽丽[1] 卢志华[1] 张新华[2] 

机构地区：[1]武汉湖北省肿瘤医院超声影像科,430079 [2]武汉湖北省肿瘤医院微创介入科,430079

出　　处：《介入放射学杂志》2014年第10期922-925,共4页Journal of Interventional Radiology

摘　　要：目的探讨超声造影(CEUS)对等回声肝癌的检出率,评价CEUS技术在射频消融(RFA)治疗等回声肝癌中的应用价值。方法术前常规超声反复检查未发现,而增强CT(CECT)或增强MRI(CEMRI)检出并经临床确诊的27例患者共31个病灶,其中11例(11个病灶)为肝细胞肝癌(HCC),16例(20个病灶)为转移性肝癌。在CEUS实时引导下对31个病灶行RFA,术后用CEUS评价肿瘤消融程度并指导补充治疗。结果 31个病灶CEUS时均检出,并全部行RFA治疗,无一例出现严重并发症。术后1个月,CEUS和CECT均提示31个病灶完全坏死,11例HCC患者血清AFP均降至正常范围,而转移性肝癌患者血清CEA、CA-199、CA-153水平均较术前明显降低,P<0.01。结论 CEUS技术可明显提高等回声肝癌的检出率,在引导等回声肝癌RFA治疗中具有重要的临床应用价值。Objective To investigate the detection rate of contrast-enhanced ultrasound （CEUS） for iso-echo liver cancers, and to evaluate the application of CEUS in treating iso-echo liver cancers with radiofrequency ablation （RFA）. Methods A total of 27 patients with liver cancers （31 lesions in total） were enrolled in this study. Of the 27 patients, hepatocellular carcinoma （HCC） was seen in 11 （11 lesions） and hepatic metastasis in 16 （20 lesions）. In all patients the diagnosis was detected by contrast-enhanced CT or contrast-enhanced MRI and was clinically confirmed. Under real-time CEUS guidance, RFA was carried out for all the 31 lesions. The ablated extent was evaluated by CEUS, and CEUS findings were used to guide the further treatment. Results All 31 lesions were detected by CEUS and were treated with RFA. No serious complications occurred after RFA. Both CEUS and CECT performed one month after RFA showed that complete tumor necrosis was seen in all the 31 lesions. After RFA the serum AFP levels in all 11 HCC patients fell to normal range, and the serum CEA, CA-199 as well as CA-153 levels in patients with hepatic metastasis decreased significantly（P〈0.01）. Conclusion CEUS can markedly increase the detection rate of iso-echo liver cancers. Besides, CEUS plays an important role in guiding the performance of RFA for iso - echo liver lesions.

关 键 词：超声造影 肝癌 射频消融 

分 类 号：R735.7[医药卫生—肿瘤]