应用超声增强剂对肝细胞癌行经导管动脉栓塞术后血流变化的研究

Blood flow changes in hepatic cellular carcinoma after transcatheter arterial embolization:a study by enhanced colour doppler flow imaging

目的 :应用经Levovist增强的彩色多普勒血流显像 (CDFI)观测肝细胞癌 (HCC)在经导管动脉栓塞术 (TAE)治疗后的血供变化 ,以评估TAE治疗HCC的效果。方法 :17例HCC患者分别于TAE术前 1周和术后 2～ 4周进行经Levovist增强的CDFI观测 ,肿瘤内的血流分布状况按 0～Ⅳ级进行半定量分析 ,并测定血流动力学参数。将治疗前后两组观测结果进行对照比较 ,并作统计学处理。结果 :TAE治疗前 ,17例HCC显示的血流信号分级为Ⅱ～Ⅳ级 ,并全部测到动脉频谱 ,最大血流速度 (Vmax)为 (5 9.64± 16.2 7)cm·s-1,TAE后血流信号分级为 0～Ⅲ级 ,较TAE前明显减少 (P <0 .0 0 5 ) ;TAE后 13例可测得动脉频谱 ,Vmax为(3 7.5 6± 15 .2 4)cm·s-1,较TAE术前明显减小 (P <0 .0 5 ) ,2例仅测得静脉频谱。结论 :经Levovist增强的CDFI可从血流分布状况和血流速度两个方面估价HCC在TAE治疗后的血供变化 ,从而可以客观地评估TAE治疗HCC的效果 。

Objective To evaluate the effect of transcatheter arterial embolization (TAE) for hepatic cellular carcinoma(HCC) by observing the blood flow changes in HCC after TAE with echo contrast agent (Levovist) enhanced colour Doppler flow imaging(CDFI).Methods The blood flow in liver tumor was examined with Levovist enhanced CDFI a week before and 2～4 weeks after TAE in 17 cases of HCC.A semi quantitative analysis of the data obtained was done in accordiance with 0 to IV grades,and the blood flow dynamic parameters were detected.A comparative analysis of the data prior and posterior to TAE was performed statistically.Results Before TAE,the flow signals in the tumors of 17 cases were classfied to Ⅱ～Ⅳ grades and all got artery Doppler spectrum with a maximum velocity(V max ) of (59.64±16.27)cm·s -1 ;after TAE,the flow signals were of 0～Ⅲ grades,obviously reduced than those before TAE( P <0.005).After TAE,13 cases got artery Doppler spectrum with a V max of (37.56±15.24)cm·s -1 .It showed that the blood flow was obviously slower than that before TAE( P <0.05);two cases got vein Doppler spectrum only.Conclusion Levovist enhanced CDFI can subjectively evaluate the effect of TAE for HCC by detecting the changes in blood distribution and flow velocity after TAE.