超声造影评价多点扇形立体定位单极冷循环射频消融治疗肝癌的疗效

Study on contrast-enhanced ultrasound in the assessment of local response to ultrasound-guided multiple-spot sector stereotaxis in unipolar cooling cycle radiofrequency ablationtreatment for hepatocellular carcinoma

目的应用超声造影(CEUS)与增强CT(CECT)评估多点扇形立体定位单极冷循环射频消融治疗肝癌(HCC)的疗效。方法对射频消融(RFA)治疗后的96例原发性肝癌患者的110个肿瘤,行即时(15m in)、1个月、6个月及1年及2年CEUS或CECT复查,观察肿瘤有无残留及复发,评价CEUS与CECT两种检查方法的优缺点。结果 CEUS105个肿瘤完全消融为95个(89.62%),肿瘤残留11个(10.38%);CECT110个肿瘤完全消融为96个(87.27%),肿瘤残留14个(12.73%)。1年生存率,<3.0 cm为90.62(29/32),≥3.0 cm为70.3(45/64)P<0.05;2年生存率,<3.0 cm为87.5(28/32),≥3.0 cm为60.9(39/64)P<0.01,<3 cm与≥3 cm比较差异有显著性意义。结论 CEUS是评价RFA疗效的有效方法,具有与CECT同样的敏感性,有较高的临床应用价值。

【Objective】 To investigate the clinical value of contrast enhanced ultrasonography（CEUS） in accessing immediate curative effects of malignant liver after multiple-spot sector stereotaxis in unipolar cooling cycle radiofrequency ablation treatment.【Methods】 After RFA for the treatment of 96 HCC cases（110 liver neoplasms）,banking immediately（n=15min）,1 month,6 month and 1 year after the CEUS or enhanced CT examination,observe with or without residual and recurrent tumor after RFA,comparing with contrast enhanced computed tomography（CECT）,evaluate the advantages and disadvantages of this two methods and optimize examination method.【Results】 complete ablation was diagnosed in 110 lesions of 87.27%（96/110） by CECT and 89.62%（95/105） in 105 lesions by CEUS.And contrast enhancement within lesions was demonstrated in 12.72 %（14/110） by CECT and 10.38%（11/105） by CEUS.All cases were followed up for two years,Survival rate for one year was 90.62%（29/32）,and two years was 87.5%（28/32） to 32 patient of tumors3.0 cm.Survival rate for one year was 70.3%（45/64）,and two years was 60.9%（39/64） to 64 patients of tumors≥3.0 cm,difference was statistically significant.【Conclusion】 CEUS is an effective way for curative effect evalution of RFA for Hepatocellular carcinoma,which has identical sensitivity with CECT and high clinical value.