实时超声造影和增强CT在肝肿瘤介入后的疗效评估

Assessment of therapeutic response of hepatoma after transcatheter arterial chemoembolization with contrast-enhanced ultrasonography and helical CT

目的探讨实时超声造影和增强CT在肝肿瘤行肝动脉插管化疗栓塞治疗(简称介入)后的应用价值。方法对21例原发性肝癌和3例肝转移癌介入治疗后进行超声造影和增强CT检查,比较两种影像技术在注射造影剂后的表现。结果超声造影和增强CT均显示肿瘤数目较彩超增多,直径较彩超增大,动脉期快速树枝状增强相同,超声造影动脉期环状增强9例,增强CT动脉期环状增强7例,余基本一致,超声造影和增强CT不同时相的增强情况间差异无显著意义(P>0.05)。结论肿瘤内血流的检测是评估疗效的手段,超声造影和增强CT都能敏感地显示肝肿瘤介入后的血供特征,超声造影具有实时性、无创性、无放射性,对肝肿瘤介入后的疗效评估有良好的应用前景。

Objective To investigate the clinical value of contrast-enhanced uhrasonography（CEUS） and helical CT in evaluating treatment response of hepatoma after transcatheter arterial chemoembolization （TACE）. Methods CEUS and helical CT were performed on 21 cases of hepatocellular carcinoma and 3 cases of hepatic metastases after TACE therapy. The enhancement patterns of CEUS and helical CT were compared. Results Both CEUS and helical CT showed more tumors with larger size than color Doppler ultrasonography. Tumors presented rapid enhancement in arterial phase on both CEUS and helical CT .There were 9 cases of rimlike enhancement on CEUS, and 7 cases of rimlike on helical CT. The enhancement features in different phases showed no significant difference between CEUS and helical CT （P〉0.05）. Conclusion Detection of intratumoral blood flow is valuable in assessing therapeutic response after TACE. Both CEUS and CT display intratumoral blood flow sensitively, CEUS is real time , non-invasive, no-radioactivity, and can be used to assess the therapeutic response on hepatoma after TACE.