诊断超声激励微泡空化增强胰腺癌血流灌注的临床研究

Clinical study of ultrasound microbubble cavitation to enhance bloodperfusion in pancreatic cancer

目的 探讨诊断超声激励微泡空化对胰腺癌血流灌注的增强效应。方法 选取经病理组织学或细胞学证实的晚期胰腺癌患者21例,在每次临床化疗结束后120 min内对病灶进行诊断超声激励微泡空化治疗,空化治疗前后分别行超声造影动态观察肿瘤血流灌注情况,并根据肿瘤区域时间-强度曲线分析峰值强度(PI)、曲线下面积(AUC),比较空化治疗前后各指标的差异。结果 21例胰腺癌患者共计进行84次化疗联合诊断超声激励微泡空化治疗,治疗后胰腺癌病灶PI由(109.19±2.64)dB增加到(110.62±2.70)dB,AUC由(4752.76±149.53)dB·s增加到(4863.67±159.77)dB·s,但与治疗前比较差异均无统计学意义(P=0.16、0.33)。结论 诊断超声激励微泡空化可能会增加胰腺癌的血流灌注量,有望改善胰腺癌因乏氧、乏血供导致的化疗抵抗问题。

Objective To investigate the enhancement of blood perfusion in pancreatic cancer by ultrasound microbubble cavitation.Methods Twenty-one patients diagnosed with advanced pancreatic cancer confirmed by histopathology or cytology were enrolled,they were treated with ultrasound microbubble cavitation within 120 min after each clinical chemotherapy.The tumor blood perfusion was dynamically observed by contrast-enhanced ultrasound before and after the cavitating treatment,respectively.The peak intensity(PI)and area under curve(AUC)were analyzed based on the time-intensity curve of the tumor region,the differences before and after cavitating treatment were compared.Results A total of 84 times of chemotherapy combined with ultrasound microbubble cavitation treatment were performed in 21 patients with pancreatic cancer.The PI of pancreatic cancer lesions increased from(109.19±2.64)dB to(110.62±2.70)dB,and the AUC increased from(4752.76±149.53)dB·s to(4863.67±159.77)dB·s after cavitation treatment,but there were no significant differences compared with the results before cavitation treatment(P=0.16,0.33).Conclusion Ultrasound microbubble cavitation therapy has the potential to enhance blood perfusion in pancreatic cancer,thereby addressing the chemotherapy resistance associated with hypoxia and inadequate blood supply.