超声造影定量参数在肝癌消融术疗效评估中的应用价值

Contrast-enhanced ultrasound time-intensity quantitative parameters assess the therapeutic response in ablation of hepatoma

目的探讨超声造影时间强度曲线(TIC)在肝癌微波消融术(MWA)疗效评定中的应用价值。方法选取肝癌患者80例,MWA术前及术后1个月、3个月、6个月分别行CEUS检查,并比较MWA前后病灶组织的TIC定量参数。结果完全灭活组术后1个月、3个月及6个月病灶的TIC均为一平直线条。部分残留或复发组术前及术后1个月、3个月、6个月肿瘤组织的上升时间(RT)、平均通道时间(MTT)、达峰时间(TTP)均明显小于同期的周围肝组织(P<0.05),内洗斜率(WIS)均明显大于同期的周围肝组织(P<0.05)。结论超声造影TIC能准确反映肝脏肿瘤、肝实质、残留或复发肿瘤以及无活性肿瘤组织间的差别,MWA术后可及时、准确地辨别出残留或复发的肿瘤组织,为肝癌MWA治疗疗效评估提供可靠的依据。

Objective To explore the value of contrast-enhanced ultrasonography （CEUS） with SonoVue and the quantitative parameters of time-intensity curve （TIC） in evaluating the effect of microwave ablation treatment （MWA） in hepatoma. Methods Totally 80 patients with liver cancer were examined with CEUS before MWA,1 month,3 months and 6 months after MWA. TIC was obtained,and then compared the parameters of lesions before MWA with the parameters after MWA. Results all TIC of the completely inactivated group show up as a straight line in 1 month,3 months and 6 months after MWA. For the residual or recur-rent group, the parameters of RT,MTT and TTP of the tumors were obviously less than the liver parenchyma（P〈0.05）. However,the parameter of WIS was obviously more than the liver parenchyma in 1 month,3 months and 6 months after MWA （P〈0.05）. Con-clusion TIC of CEUS can reflect the minute difference among liver tumors,hepatic parenchyma,and the residual tumor,depict residual or recurrent tumor immediately after MWA,therefore providing a reliable bases for assessing the therapeutic response in MWA.