超声造影联合实时影像虚拟导航系统在困难肝癌射频消融治疗应用  

The value of contrast-enhanced ultrasound combined with real-time imaging virtualnavigation system in the treatment of radiofrequency of difficult liver cancer

作　　者：高军喜[1] 韩伟[1] 谷昊[1] 王颖鑫[1] 宋涛[1] GAO Jun-xi;HAN Wei;GU Hao;WANG Ying-xin;SONG Tao(The First Affiliated Hospital of Xinjiang Medical University,Urumqi 830011,China)

机构地区：[1]新疆医科大学第一附属医院,新疆乌鲁木齐830011

出　　处：《中国临床医学影像杂志》2020年第7期495-499,共5页Journal of China Clinic Medical Imaging

基　　金：新疆维吾尔自治区自然科学基金项目(2016D01C269)。

摘　　要：目的:探讨超声造影联合实时影像虚拟导航系统对经皮困难肝癌进行射频消融治疗的可行性及安全性。方法:实验组41例患者共52个困难病灶采用超声造影联合实时虚拟影像导航系统辅助下经皮进行射频消融治疗,同期对照组40例患者共54个病灶部分采用增强CT引导下、部分采用经腹腔镜及开腹后超声引导下进行射频消融治疗,比较两组术中及术后并发症及术后残留率及复发率差异。结果:实验组41例患者的52个病灶均比较成功的完成超声和CT或MRI图像融合,图像融合成功率为100%,图像对位用时10~30 min,平均15.2 min,两组81例患者治疗中及治疗后发生3例较严重并发症,其中术中发生肿瘤破裂出血1例,血性胸水1例,肝脓肿1例,其余病例均未发生严重并发症,两组术中及术后疼痛评分、术中出血及术后发热比较差异具有统计学意义(P<0.05),疼痛评分,术后出血及发热概率实验组均低于对照组,术后1月两组病灶肿瘤残留率、术后3月、6月两组治疗后复发率比较差异无统计学意义。结论:超声造影联合实时影像虚拟导航系统对经皮困难肝癌进行射频消融治疗与传统方法比较肿瘤残留率及复发率无差异,同时疼痛及出血并发症发生率较低,具有较好的可行性及安全性。Objective: To investigate the feasibility and safety of radiofrequency ablation for percutaneous difficult liver cancer with enhanced-contrast ultrasound combined with real-time imaging virtual navigation system. Methods: Forty-one patients with 52 lesions in the experimental group were treated with radiofrequency ablation assisted by enhanced-contrast ultra-sound combined with real time virtual imaging navigation system. In the control group of 40 patients with 54 lesions were treated with radiofrequency ablation guided by enhanced CT or guided by ultrasound after laparoscopic and open the abdomen,and the differences in operative and postoperative complications, residual and recurrence rates were compared between the two groups. Results: Fifty-two lesions in the experimental group successfully completed ultrasound and CT or MRI image fusion,the image fusion success rate was 100%, and the image alignment time was 10~30 min, with an average of 15.2 min. Three of the 81 patients in the two groups developed serious complications during and after treatment, including one case of ruptured tumor hemorrhage, one case of bloody chest water, and one case of liver abscess. No serious complications occurred in the remaining cases. There was a statistically significant difference between the two groups in pain score, bleeding and fever(P<0.05). The pain score, the probability of bleeding and postoperative fever of the experimental group were all lower than those of the control group. There was no significant difference in the recurrence rate between the two groups after treatment in three and six months. Conclusion: The radiofrequency ablation of percutaneous liver cancer treated with ultrasound combined with real time imaging virtual navigation system has low incidence of residual and recurrence rate, pain and hemorrhage complica-tions, and is feasible and safe.

关 键 词：肝肿瘤 导管消融术 超声检查 

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