转移性肝癌射频消融治疗的超声造影评价

Evaluation of short term therapeutic response of radiofrequency ablation of metastatic liver cancer with contrast-enhanced ultrasonography

目的探讨超声造影评价转移性肝癌射频消融治疗的近期消融效果的价值。方法回顾性分析转移性肝癌射频消融治疗患者43例(56个病灶)的近期随访资料,包括病灶的超声造影与增强CT检查、实验室检查和临床表现等,比较分析超声造影与增强CT检查所见及对肿瘤灭活程度的判断情况。结果超声造影显示56个病灶中47个造影灌注各期均无增强,9个病灶边缘少部分组织在动脉期不规则增强,内部大部分组织在各期均无增强;增强CT显示56个病灶中49个造影灌注各期均无增强,7个病灶边缘少部分组织在动脉期不规则增强,内部大部分组织在各期均无增强。超声造影与增强CT对转移性肝癌射频消融治疗后病灶灭活程度比较,差异无统计学意义(P=0.788);对灭活效果的判定具有较高的一致性(K=0.635,P<0.001)。结论超声造影可以较准确检查转移性肝癌射频消融的肿瘤灭活范围和发现残留病灶,具有与增强CT评价肝癌射频消融治疗近期疗效的相似效果。

Objective To evaluate the usefulness of contrast-enhanced ultrasonography in assessing the short term therapeutic response of percutaneous radiofrequency ablation in patients with metastatic liver cancer.Methods Archives of 43 patients with metastatic liver cancer（56 lesions） undergoing percutaneous radiofrequency ablation were reviewed retrospectively,including contrast-enhanced sonography,contrast-enhanced computed tomography,laboratory tests and clinical manifestation.Findings and detection of residual tumor in contrast-enhanced sonography,contrast-enhanced computed tomography were studied.Results Of the 56 lesions on contrast-enhanced sonography,47 lesions did not show enhancement,9 lesions showed marginal heterogeneous enhancement at arterial phase but absent enhancement in the central part.Of the 56 lesions on contrast-enhanced computed tomography,49 lesions did not show enhancement,7 lesions showed marginal heterogeneous enhancement at arterial phase and absent enhancement in the central part.There was no significant difference between the contrast-enhanced sonography and contrast-enhanced computed tomography for the assessment of the short term therapeutic response of percutaneous radiofrequency ablation in patients with metastatic liver cancer（P=0.788）,and the agreement of those between the two modalities was good（K=0.635,P〈0.001）.Conclusion Contrast-enhanced sonography has almost equivalent to that of contrast-enhanced CT in evaluating the short term therapeutic response of percutaneous radiofrequency ablation in patients with metastatic liver cancer.