超声造影评价射频治疗肝细胞癌疗效

Contrast-enhanced ultrasound in the assessment of efficacy of radiofrequency ablation for hepatocellular carcinoma

目的探讨超声造影在肝细胞癌射频治疗术后疗效评估中的临床应用价值。方法对21例因单发病灶肝细胞癌接受射频治疗后患者,应用超声对比剂SonoVue与低机械指数实时造影技术进行超声造影成像,观察病灶坏死范围,并结合增强CT、MRI与血清甲胎蛋白水平评定有无肿瘤复发或局部残留。结果21个病灶超声造影后,毁损灶最大平均直径约(4.7±0.3)cm。17例毁损灶较原病灶增大;8例原病灶旁或病灶周边有动脉期强化灶,提示肿瘤局部复发,1例复发灶位于肝脏膈顶部而未发现。结论超声造影可显示射频治疗后毁损灶的范围,对术后肿瘤消融不全或局部复发的诊断具有较高敏感性。

Objective To evaluate the value of contrast enhanced ultrasound （CEUS） in the assessment of efficacy of radiofrequency ablation （RFA） treatment for hepatocellular carcinoma （HCC）. Methods Twenty-one patients with hepatocellular carcinoma treated with RFA underwent CEUS with SonoVue as contrast agent. Therapeutic effects of RFA were e- valuated with CEUS combining with contrast CT, MRI, or the serum levels of alpha fetoprotein （AFP）. Results After treatment of RFA, the lengths of the major axis at the maximal necrotic areas, enlarged in 17 patients, decreased in 1 patient, and remained the same in 3 patients, resulting the mean length of maximal necrotic area as （4.7±0. 3）cm. Local recurrences were diagnosed in 8 patients with CEUS, but one lesion locating in the hepatic dome was missed, and the patients were retreated with RFA and/or percutaneous ethanol injection （PED. All patients survived during the following-up. Conclusion CEUS is a valuable method for curative effect evaluation of RFA and detection of residual and tumor recurrence in patients with HCC.