Sonazoid与SonoVue应用于超声引导下经皮微波消融治疗小肝癌的对比研究

Value of Sonazoid and SonoVue in percutaneous microwave ablation of small hepatocellular carcinoma under ultrasound guidance:a comparative study

目的比较Sonazoid与SonoVue应用于超声引导下经皮微波消融治疗小肝癌的临床价值。方法选取我院超声引导下经皮微波消融治疗小肝癌患者67例,均应用超声造影观察肿瘤显影情况并进行穿刺布针,根据术中使用造影剂的不同分为Sonazoid组25例和SonoVue组42例,比较两组穿刺布针难度评分;消融后3个月内行增强影像学(增强MRI、增强CT或超声造影)检查评估其近期疗效。结果Sonazoid组穿刺布针难度评分2.0~2.7分,平均(2.28±0.29)分,SonoVue组穿刺布针难度评分2.0~4.7分,平均(2.95±0.85)分,两组比较差异有统计学意义(P<0.05)。消融后3个月内行增强影像学检查显示,Sonazoid组完全消融率为100%(25/25),SonoVue组完全消融率为95.2%(40/42),两组比较差异无统计学意义。结论Sonazoid与SonoVue超声造影在常规超声显影不清晰的小肝癌消融术中均有较好的临床应用价值;相较于SonoVue,Sonazoid具有独特的后血管相,可使肿瘤长时间清晰显影,便于术者进行连续操作、精准穿刺布针,有助于提高消融疗效。

Objective To compare the clinical value of Sonazoid and SonoVue in percutaneous microwave ablation of small hepatocellular carcinoma under ultrasound guidance.Methods Sixty-seven patients with small hepatocellular carcinoma treated underwent percutaneous microwave ablation therapy under ultrasound guidance in our hospital were selected.Contrast-enhanced ultrasound(CEUS)was used to visualize tumors,and puncture needles were arranged according to the visualization.The patients were divided into Sonazoid group(25 cases)and SonoVue group(42 cases)according to the different contrast agents used during the operation.The difficulty score of needle arrangement was compared between the two groups.The short-term efficacy was evaluated by performing contrast-enhanced imaging(CEMRI,CECT,or CEUS)within 3 months after ablation.Results The difficulty score of needle arrangement in the Sonazoid group were 2.0~2.7 points,with an average of(2.28±0.29)points,while those in the SonoVue group were 2.0~4.7 points,with an average of(2.95±0.85)points.The difference between the two groups was statistically significant(P<0.05).Within 3 months after ablation,contrast-enhanced imaging showed that the complete ablation rate in the Sonazoid group was 100%(25/25),while that in the SonoVue group was 95.2%(40/42).There was no significant difference between the two groups.Conclusion The clinical application value of CEUS based on Sonazoid and SonoVue are significant in providing guidance during the ablation of small hepatocellular carcinoma with unclear conventional grayscale ultrasound imaging.Compare with SonoVue,the Sonazoid exhibits a distinctive post-vascular phase that enables prolonged and clear visualization of the tumor.This facilitates uninterrupted operation and precise needle arrangement by operators,thereby potentially enhancing ablation efficacy.