超声造影在肝细胞癌热消融术后复发监测的研究进展  

Progress in monitoring the recurrence of hepatocellular carcinoma after thermal ablation with contrast-enhanced ultrasound

作　　者：夏永旭 林元强[1] 王辉[1] XIA Yongxu;LIN Yuanqiang;WANG Hui(Department of Ultrasound,China-Japan Union Hospital,Jilin University,Changchun 130033,China)

机构地区：[1]吉林大学中日联谊医院超声科,吉林长春130033

出　　处：《中国实验诊断学》2025年第2期224-229,共6页Chinese Journal of Laboratory Diagnosis

基　　金：吉林省卫生科研人才专项项目(2023SCZ59)。

摘　　要：肝细胞癌是全球范围内发病率和死亡率较高的恶性肿瘤。热消融术因其微创、高效的特点被广泛应用于肝细胞癌的治疗。然而,热消融术后的高复发率严重影响患者的长期生存率。超声造影不仅能够实时评估消融效果,还可通过分析增强模式监测复发风险。与CT/MRI对比,CEUS时间分辨率高、灵敏度优。同时,CEUS提示肝癌热消融后复发有诸多征象,如动脉期强化特征、消融边缘、微血管侵犯等与复发相关。此外,多模态超声造影、融合成像以及三维超声造影等新技术的出现,进一步提升了影像诊断的精准性与治疗指导能力。本综述总结了肝细胞癌热消融术后复发的主要CEUS征象,探讨了影响复发的相关危险因素,以及目前的研究复发和潜在的干预策略,为将来该领域的研究以及新技术的出现提供参考。Hepatocellular carcinoma(HCC)is a highly prevalent and lethal malignancy globally.Thermal ablation,characterized by its minimally invasive nature and efficacy,is extensively utilized in the treatment of HCC.However,the high recurrence rate following thermal ablation significantly impacts patient long-term survival.Contrast-enhanced ul-trasound(CEUS)not only evaluates ablation efficacy in real-time but also monitors recurrence risk through the analysis of enhancement patterns.Compared to CT/MRI,CEUS offers superior temporal resolution and enhanced sensitivity.Moreover,CEUS has identified several indicators of HCC recurrence post-thermal ablation,including arterial phase en-hancement,changes at the ablation margin,and microvascular invasion,all of which are associated with recurrence.Ad-ditionally,the advent of new technologies such as multimodal contrast ultrasound,fusion imaging,and three-dimension-al contrast ultrasound has further improved diagnostic accuracy and guided therapeutic interventions.This review sum-marizes the key CEUS findings indicative of recurrence after thermal ablation of HCC,discusses associated risk factors for recurrence,highlights current research advancements,and suggests potential intervention strategies,providing valua-ble insights for future research and technological development in this field.

关 键 词：肝细胞癌 热消融术 超声造影 复发监测 

分 类 号：R735.7[医药卫生—肿瘤]