超声造影评价肝脏恶性肿瘤射频消融术后疗效  

Evaluation of curative effects on liver malignant tumor after radiofrequency ablation by contrast-enhanced ultrasound

作　　者：陈重[1] 赖小今[1] 廖明松[1] 邓旦[1] 徐丹[1] 李茜[1] 陶杰[1] 吴晓波[1] 

机构地区：[1]成都军区总医院超声科,成都610083

出　　处：《西南国防医药》2015年第11期1216-1218,共3页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的探讨超声造影技术（CEUS）用于评价肝脏恶性肿瘤射频消融术后疗效的价值。方法 243例患者肝内398个恶性肿瘤行射频消融术后1个月,分别行常规超声、CEUS及增强CT检查（CECT）,对三种诊断方法的敏感性、特异性及准确性进行比较。结果常规超声诊断完全灭活病灶152个（38.2%）,残留病灶246个（61.8%）,治疗区显示为边界较清晰的类椭圆形或花瓣样不均质稍强或强回声区域。CEUS诊断完全灭活病灶309个（77.6%）,表现为该区域各时相均完全无增强;残留病灶89个（22.4%）,动脉相大部分表现为偏于一侧的结节状高增强或等增强,少部分病灶显示为不规则的略呈网状或厚薄不均的半环状及环状高增强;门脉相表现大部分呈低增强,部分呈等增强;延迟相所有病灶呈低增强,残存病灶面积存活率约为10%～60%,平均面积存活率约30%。CEUS的诊断敏感性、特异性及准确性略优于CECT,但差异无统计学意义（P〉0.05）,而CEUS与CECT诊断能力均明显优于常规超声（P〈0.01）。结论 CEUS可有效评价肝脏恶性肿瘤射频消融术后早期疗效,具有较高的诊断准确性。Objective To explore the significance of contrast-enhanced ultrasound （CEUS） in the evaluation of efficacy on liver malignant tumor after radiofrequency ablation （RFA）. Methods 398 malignant tumors in 243 patients underwent RFA, and one month later, they received conventional ultrasound, CEUS, and contrast-enhanced CT （CECT）. Comparison was made in the sensitivity, specificity, and accuracy among the three diagnostic methods. Results The conventional ultrasound showed 152 focuses with complete inactivation （38.2%） and 246 residual focuses （61.8%）. The treated area presented oval or petal like slight hyper-echo or hyper-echo zones. CEUS showed 309 focuses with complete inactivation （77.6%）, and that area had no enhancement at any phases. There were 89 residual tumors （22.4%）. Most arterial phases showed nodosity hypervenhancement or isovenhancement at one side. Few focuses showed unsteady net-like or uneven semiring or circularity hyper-enhancement. In portal phases, most presented hypo-enhancement, and parts of them showed iso-enhancement. In late phases, all the focuses showed hypo-enhancement; the survival rate of residual focus area was 10% to 60%, and the survival rate of mean area was 30%. The diagnostic sensitivity, specificity, and accuracy of CEUS were slightly superior to those of CECT, but the differences were not significant （P 〉 0.05）. The diagnostic ability of CEUS and CECT was superior to that of the conventional ultrasound （P 〈 0.01）. Conclusion CEUS can effectively evaluate the early curative effects on liver malignant tumor after RFA, which has a high diagnostic accuracy.

关 键 词：超声造影 射频消融术 肝脏肿瘤 增强CT 

分 类 号：R445.1[医药卫生—影像医学与核医学] R735.5[医药卫生—诊断学]