肝癌肝动脉化疗栓塞术后常规超声与超声造影引导下微波消融疗效比较

Comparison of therapeutic effect between conventional ultrasound guided and contrast enhanced ultrasound guided microwave ablation in the treatment of hepatic carcinoma after TACE

目的研究与常规超声相比，超声造影（CEUS）引导微波消融治疗肝动脉化疗栓塞术（TACE）后肝癌有无优越性。方法71例原发性肝癌患者TACE术后行微波消融治疗，根据引导方法不同分为A、B两组。A组运用常规彩超引导；13组运用超声造影引导，术后1周复杏超声造影、增强CT或增强MRI以评价疗效。结果A组40个病灶，31个病灶一次微波消融治疗完全灭活，9个病灶一次治疗未能完全灭活。B组34个病灶，32个病灶一次治疗完全灭活，2个病灶一次治疗未能灭活。二者有统计学差异（P〈0．05）。结论运用超声造影引导可以提高肝癌TACE术后微波消融疗效。

Objective To investigate whether contrast enhanced ultrasound （CEUS） guided microwave ablation is advantageous over conventional ultrasound guided microwave ablation for the treatment of hepatic carcinoma after tran- scatheter arterial ehemoembolization （TACE）. Methods 71 patients with primary carcinoma of the liver received micro- wave ablation after TACE treatment. These patients were divided into 2 groups according to different guiding techniques. Group A received conventional color Doppler ultrasound guided microwave ablation and group B received CEUS guided microwave ablation. The therapeutic effect was evaluated by CEUS, enhanced CT or enhanced MRI 1 week after the mi- crowave ablation. Results Of the 40 lesions in group A, 31 lesions were completely inactivated after one microwave ab- lation proeedure, 9 lesions were incompletely inactivated after one procedure. Of the 34 lesions in group B, 32 lesions were inactivated after one procedure, 2 lesions were incompletely inactivated after one procedure. The rate of inactivation of the lesions between group A and group B was statistically significant （ P 〈 0.05 ）. Conclusion CEUS guidance can improve the efficacy of microwave ablation for the treatment of hepatic carcinoma after TACE.