彩色多普勒血流显像在肝癌超声引导下介入性治疗中的应用

Clinical application of Color Doppler Flow Imaging in the of ultrasound-guided interventional therapy for liver cancer

目的 探讨彩色多普勒血流显像法（CDFI）在肝癌超声引导下介入性治疗的应用价值,以便更好地指导肝癌患者的临床治疗。方法 回顾性分析2014年9月至2015年6月62例经病理组织学诊断明确为肝癌患者资料,经超声引导下介入性治疗后,适用该仪器在相同条件下,沿相同切面方向做对比观察分析。62例患者的73个结节,其中的53例的62个结节,行超声引导下放射性同位素钇90放疗,部分患者配合无水酒精治疗。9例11个病灶仅行超声引导下无水酒精治疗。将治疗前后两组数据录入到SPSS19.0统计学软件处理,血供变化、血流分布等均为计数资料,以[n（%）]表示,行χ2检验,以P〈0.05为数据对比差异有统计学意义。结果 62例肝癌患者的73个肿块,经治疗86.30%的肿块明显缩小。治疗前62例患者中80.65%结节显示肿块内有血流,9例肝转移癌中44.44%有瘤内血流;治疗后0级64.52%明显高于治疗前0级25.81%,差异有统计学意义（χ2=16.686,P〈0.05）,而Ⅰ级、Ⅱ级、Ⅲ级分别为20（32.26%）例、21（33.87%）例、16（25.81%）,多于治疗后的15（24.19%）例、9（14.52%）例、9（14.52%）例,其中Ⅱ级血流分级治疗前后具有显著性差异（P〈0.05）;彩色多普勒观察到药物多分布于血管周围,经无水酒精治疗后,2~3周内血流明显减少,放射性同位素钇90治疗后1个月血流明显减少,治疗后的彩色多普勒超声回声增强,与血流的较少或消失及肿块缩小或消失相一致。结论 通过彩色多普勒血流显像中治疗前后的血流变化可以观察肝癌患者的治疗效果,同时作为超声能引导肝癌的介入性治疗,具有较高的临床应用价值。

Objective To explore the clinical application of Color Doppler Flow Imaging （ CDFI） in the of ultrasound-guided interventional therapy for liver cancer , in order to better guide the clinical treatment of liver cancer patients . Methods From September 2014 to June 2015, 62 patients with pathological histology diagnosis of liver cancer were enrolled in this study , all of whom received ultrasound guided interventional therapy , applying to the instrument in the same conditions , and along the same plane direction observation analysis were performed .Among 73 nodes in 62 patients, 62 nodes in 53 patients underwent ultrasound guided 90yttrium radiation and anhydrous alcohol treatment in some cases .Other 11 nodes in 9 patients only received ultrasound guided anhydrous alcohol treatment .Statistical analysis were performed by using SPSS19.0 software.Counting data were expressed as [ n] （%） and were examined byχ2 test, including change blood supply and blood flow distribution .P＆lt;0.05 was considered as significant difference. Results Among 73 lesions in 62 patients, volume of 86.30% mass were significantly decreased after treatment.Before treatment, 80.65%in 62 patients showed blood flow , and 44.44% mass in 9 cases of hepatic metastatic carcinoma showed blood flow .After treatment, 64.52% of the level 0 was significantly higher than 25.81%before treatment, with significant difference （χ2 =16.686, P＆lt;0.05）. However, there were 20 cases （32.26%） of grade Ⅰ, 21 cases （33.87%） of grade Ⅱ and 16 cases （25.81%） of grade Ⅲ cases, which more than 15 cases （24.19%）, 9 cases （14.52%） and 9 cases （14.52%） after treatment respectively .with significant difference in comparing the grade Ⅱ of blood flow before and after treatment （P＆lt;0.05）.Color doppler could observe drugs throughout the blood vessels . After treatment with anhydrous alcohol , blood flow were decreased significantly in 2 ~3 weeks .Radioactive isotope 90yttrium could decrease blood flow of tumors significantly one month after treatment with enhanced color doppler ultrasonic echo ment , in line with the decrease or disappear of blood flow and tumors shrink or disappear . Conclusion By using color doppler flow imaging to observe blood flow change before and after treatment could indicate the therapeutic effect of patients with liver cancer , as well as guiding the interventional therapy for liver cancer , which worth of wider clinical application .