超声引导下肝癌微波凝固治疗的疗效及声像图分析  

Therapeutic effect and sonogram analysis of liver cancer by US-guided microwave coagulation

作　　者：王学梅[1] 刘艳君[1] 欧国成[1] 周旭[1] 李平[1] 董鲜普[1] 陶春梅[1] 杨向红[2] 

机构地区：[1]中国医科大学附属第一医院超声中心,辽宁沈阳110001 [2]中国医科大学基础医学院病理教研室,辽宁沈阳110001

出　　处：《中国临床医学影像杂志》2003年第4期264-266,270,共4页Journal of China Clinic Medical Imaging

基　　金：辽宁省沈阳市科委资助;课题项目编号[(1999)70]

摘　　要：目的:探讨超声引导下经皮微波凝固治疗(MCT)肝癌的声像图改变及疗效。资料与方法:经穿刺活检、手术病理证实的肝癌患者25例,共32个结节,进行单次或分点多次凝固治疗,对比术前、术后患者的声像图改变、病理、AFP及ALT的变化。结果:治疗过程中,结节回声增强,直至覆盖整个病灶。术后结节以不均质低回声为主。MCT后有20个结节进行病理检查,80%(16?20)完全坏死,其中直径<3.5cm的结节坏死率100%(5?5)。随访半年,71.9%结节缩小。CDFI显示治疗后肿瘤血供消失68.8%,减少31.2%。治疗后AFP81.3%(13?16)降低或恢复正常。ALT呈一过性升高,3周内96%(24?25)恢复术前水平。结论:超声引导微波凝固治疗可以有效灭活单发、直径<3.5cm的肝癌结节,对直径≥3.5cm的结节,多次凝固可不同程度控制肿瘤增长。声像图表现有助于判断微波治疗的疗效。Objective:To investigate the sonogram and therapeutic effect of US -guided percutaneous microwave coagula-tion therapy(MCT)for liver cancer.Methods:Twenty-five cases (32nodules)with liver cancer confirmed by histology were treated by mono-stage or multi-stage,multi-point coagulation.To determine the effects of MCT,changes of tumor size and tu-mor echo were evaluated and compared with pre-treatment sonography,the serum level of AFP and ALT pre-and post-treat-ment were also compared,respectively.Re sults:①During coagulation,echo in nodule was enhanced significantly until cover-ing the whole nodule;the size of 23nodules(71.9%)became smaller6months after MCT.In20nodules after MCT the necrotic rate was80%(16?20)confirmed by histology,in5nodules with diameter less than3.5cm the necrotic rate was100%.②After MCT,the intra-tumor blood flow disappeared in22nodules(68.8%)and decreased in10nodules(31.2%)on CDFI.③The serum level of AFP became normal or decrease in13cases (81.3%)with hepatocellular carcinoma.ALT level slightly in-creased and24cases(96%)decreased to the pre-treatment level in3weeks.Conclu sion:①US-guided percutaneous MCT can effectively eliminate the viability of solitary cancer nodule with a diameter less than3.5cm.As to diameter larger than3.5cm,enlargement of nodules can be controlled in variable degree by multi-point coagulation.②Sonography may be valuable in eval-uating the effect of MCT.

关 键 词：肝肿瘤 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]