超声多普勒技术评价肝癌射频治疗后肝脏及肿瘤内血液动力学变化

Color Doppler ultrasonography in the evaluation of hemodynamic changes in live and hepatic carcinoma before and after cluster electrode radio frequency ablation

目的：利用彩色、能量、频谱多普勒显像技术对肝癌集束电极射频治疗术前后肿瘤的血供情况、肝动脉、门静脉血流动力学进行观察，评价肝癌射频治疗效果。方法：采用 Sequoia 512型彩色、能量多普勒血流显像对 56例肝癌 69个肿块集束电极射频治疗术前后 1周、 1月及 3月肝脏及肿瘤的血流动力学变化进行观察。结果：集束电极射频治疗后 1周、 1月肝脏动脉、瘤周动脉血流速度较术前明显降低，门脉血流速度无明显变化。治疗前 56例肝癌 69个结节中 60个可测及血流信号，以动静脉混合供血为主；治疗后有血流的 60个肿块中 18个血流减少， 33个完全消失， 9例无变化。肿瘤内Ⅱ～Ⅲ级供血明显减少。 21例 3个月复查， 3例出现血供， 2例再次治疗血流信号消失。结论：彩色、能量多普勒对观察肝癌射频治疗前后血流的变化可以评价肝癌射频治疗效果，为再次治疗提供依据。

Objective:Blood supply of cancerous nodules and hemodynamic changes of hepatic artery(HA)and portal vein(PV)in patients with hepatic carcinoma before and after cluster electrode radio frequency ablation(CERFA)were observed with color Doppler ultrasonography in order to evaluate clinical treatment effect.Materials and Methods:The hemodynamic changes of HA,PV and 69 lesions in 56 patients with hepatic carcinoma were investigated by CDFI and PDI before and one week,one month and three months after CERFA with Sequoia 512 ultrasound equipment.Results:One week after radio frequency,the velocities of blood flow in HA and around the lesions decreased(P<0. 05)， while the velocity of PV had no change.Blood signals were found in 60 cancerous nodules before CERFA,while reduced in 18,disappeared in 33 and had no change in 9 lesions after treatment.The supplying blood flow signals graded asⅡ andⅢ decreased significantly.In 21 cases who were reexamined 3 months later,blood flow signals reoccurred in 3 and 2 of them disappeared again after the second CERFA.Conclusion:CDFI and PDI were useful in assessing the therapeutic effect of CERFA in patients with hepatic cancer and may provide some information for the next treatment.