超声造影评价特殊部位肝癌微波消融联合补充无水乙醇治疗的应用价值  

A Study on the Value of Microwave Ablation with Anhydrous Ethanol in the Treatment on Special Site Liver Cancer by Contrast-enhanced Ultrasound

作　　者：彭红艳[1] 余松远[1] 贺飞[1] 李小晶[1] 李蕾[1] 秦梦斌 张玲[1] 

机构地区：[1]武汉科技大学附属天佑医院超声医学科,武汉市430064

出　　处：《中国超声医学杂志》2017年第3期241-244,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨超声造影实时动态观察特殊部位肝癌微波消融联合无水乙醇治疗的应用价值。方法对45例特殊部位肝癌患者,共73个病灶,分为两组对比观察:微波消融组(A组)和微波消融+无水乙醇联合治疗组(B组)。A组共32个,其中邻近大血管或胆管处6个,靠近膈肌或肝包膜处16个,邻近周围重要器官处10个;B组共41个,其中邻近大血管或胆管处9个,靠近膈肌或肝包膜处19个,邻近周围重要器官处13个;每组分别行超声造影检查,同期行增强MRI进行比较。结果 (1)超声造影检查发现A组完全消融22个,未完全消融10个,完全消融率为68%;B组完全消融37个,未完全消融4个,完全消融率为90%。(2)增强MRI检查发现A组完全消融20个,未完全消融12个,完全消融率为62%;B组完全消融35个,未完全消融6个,完全消融率为85%。(3)A组与B组分布部位差异无统计学意义(P>0.05),超声造影发现B组疗效优于A组,差异有统计学意义(P<0.05);超声造影与增强MRI间比较差异无统计学意义(P>0.05)。结论微波消融联合无水乙醇治疗特殊部位肝癌有较好的疗效,超声造影能实时动态观察肝癌血流灌注情况,对特殊部位肝癌治疗有重要的临床指导意义。Objective To explore the value of microwave ablation （MWA） with anhydrous ethanol in the treatment on special site hepatocellular carcinoma by the real-time contrast-enhanced ultrasound （CEUS）. Methods 45 patients with 73 lesions of special sit.e hepatocellular carcinoma were involved in this study. Group A including 32 lesions were treated by microwave ablation,with 6 lesions nearby large blood vessels or bile duct, 16 lesions nearby the dia- phragm or liver capsular, and 10 lesions adjacent to important organs ; Group B including 41 lesions were treated by microwave ablation with anhydrous ethanol, with 9 lesions nearby large blood vessels or bile duct, 19 lesions nearby the diaphragm or liver capsular, and 13 lesions adjacent to important organs, each lesion was observed by CEUS and enhanced magnetic resonance imaging （MRI）respectively. Results （1） 22 lesions were completely treated and 10 lesions were incompletely treated by MWA with CEUS, complete ablation rate was 68% ; 37 lesions were completely treated and 4 lesions were incompletely treated by MWA with anhydrous ethanol, complete ablation rate was 90%. （2）20 lesions were completely treated and 12 lesions were incompletely treated by MWA with enhanced MRI, com- plete ablation rate was 62%;35 lesions were completely treated and 6 lesions were incompletely treated by MWA with anhydrous ethanol, complete ablation rate was 85 %. （3）The distribution site between Group A and Group B is not sta- tistically significant （P^O. 05）, the therapy of MWA with anhydrous ethanol is superior to the MWA through CEUS or enhanced MRI, the difference was statistically significant （P〈0. 05）;the difference of methods between CEUS and enhanced MRI is not statistically significant （P〈0.05）. Conclusions Curative effect of MWA with anhydrous ethanol is preferable to MWA individually, and the blood flow perfusion was observed by CEUS,which should be an efficient and real-time method for MWA with anhydrous ethanol in the treatment on special si

关 键 词：超声造影 微波消融 特殊部位肝癌 无水乙醇 

分 类 号：R445.1[医药卫生—影像医学与核医学] R735.7[医药卫生—诊断学]