超声造影对经导管肝动脉栓塞化疗术治疗肝细胞癌患者效果的评价  

Contrast-enhanced ultrasound for evaluation of efficacy of transcatheter hepatic artery embolization in patients with hepatocellular carcinoma

作　　者：韩鹏 费翔[1] 姜波[1] 贺崇 罗渝昆[1] 王志军[2] Han Peng;Fei Xiang;Jiang Bo;He Chong;Luo Yukun;Wang Zhijun(Department of Ultrasound,the First Medical Center of Chinese PLA General Hospital,Beijing 100853,China;Department of Interventional Radiology,the First Medical Center of Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军总医院第一医学中心超声诊断科,北京100853 [2]解放军总医院第一医学中心介入放射科,北京100853

出　　处：《中华医学超声杂志（电子版）》2021年第5期487-494,共8页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的探讨采用经肝动脉超声造影评价经导管肝动脉栓塞化疗(TACE)术后即刻栓塞效果,并预测肿瘤短期疗效。方法选取2018年9月至2019年3月在解放军总医院第一医学中心因肝肿瘤行TACE治疗的肝细胞癌患者39例,共50个肝细胞癌病灶术前及术后即刻行经肝动脉超声造影,依据术后与术前肿瘤内部增强最大面积占比及术后与术前引流区最大包围范围占比进行分组,采用Spearman相关分析将上述分组分别与TACE术后1~3个月内的MRI结果进行相关性分析。结果术后即刻瘤内增强占比及术后引流区包围范围占比评价栓塞效果与实体瘤治疗疗效评价标准的修订标准(mRECIST)判断短期疗效结果均有相关性,其中术后引流区包围范围占比相关性更高(r=0.516,P<0.001,r=0.716,P<0.001)。结论经肝动脉超声造影评估TACE术后即刻栓塞效果与m RECIST短期疗效评估标准具有较高的相关性,可为预测肿瘤术后短期疗效提供良好的影像学参考。Objective To investigate the feasibility of evaluating the effect of embolization by transhepatic arterial contrast-enhanced ultrasonography immediately after transarterial chemoembolization(TACE)to predict the short-term curative effect for hepatocellular carcinoma(HCC).Methods A total of50 HCC lesions in 39 patients treated by TACE underwent transhepatic artery contrast-enhanced ultrasonography before and immediately after operation at the First Medical Center of Chinese PLA General Hospital from September 2018 to March 2019.According to the maximum area ratio of internal enhancement of the tumor after surgery and before surgery and the maximum covering ratio of drainage area before and after surgery,Spearman correlation analysis was used to compare MRI results within 1 to 3 months after TACE between groups.Results The effect of embolization evaluated by immediate postoperative tumor enhancement ratio and postoperative covering ratio of drainage area was related to the short-term curative effect judged by modified response evalution criteria in solid tumors(mRECIST),and the postoperative covering ratio of drainage area had a more significant correlation(r=0.516,P<0.001 and r=0.716,P<0.001,respectively).Conclusion The evaluation of embolization effect immediately after TACE by transhepatic artery contrast-enhanced ultrasonography has a high correlation with the short-term curative effect evaluated by m RECIST,which can provide a good imaging reference value for predicting the short-term curative effect after tumor operation.

关 键 词：经肝动脉超声造影 肝细胞癌 经导管肝动脉栓塞化疗 

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]