高强度聚焦超声治疗肝癌的近期疗效评价

Treatment of hepatocarcinoma with high intensity focused ultrasound

目的 评价高强度聚焦超声 (HIFU )治疗肝癌的近期效果。方法 对临床病理确诊的 6例肝癌患者 ,选择了 8个病灶接受HIFU治疗 ,根据治疗前后磁共振 (MRI)、血清肿瘤标记物和临床症状的变化等评估近期疗效。结果 MRI表现 :病灶由治疗前的T1WI低信号、T2WI高信号 ,变成治疗后的T1WI高信号、T2WI低信号 (病灶完全覆盖 )或高低不一的混杂信号 (病灶部分覆盖 ) ,呈现完全或部分凝固性坏死的特征性表现 ;动态增强扫描显示病灶由治疗前的信号强化 ,变成治疗后的信号强化减少或消失。患者治疗后血清肿瘤标记物有不同程度的下降、肝区疼痛有不同程度的缓解 ;所有患者治疗后未出现重要脏器功能明显异常和邻近组织脏器损伤等严重并发症。结论 HIFU治疗肝癌局部疗效明确 ,且安全、可行 ,为临床无创性治疗肝癌提供了一种新的手段。

Objective To evaluate the near efficiency of high intensity focused ultrasound (HIFU) in the treatment of hepatocarcinoma.Methods Six patients with 8 masses of hepatic carcinomas were sonicated by HIFU. MRI,serum tumor signs and clinical symptoms were evaluated before and after HIFU sonication for assessing the efficiency of treatment.Results On the MRI,hypointensity of tumor tissues on T1WI and hyperintensity of tumor tissues on T2WI before HIFU and they were changed into hyperintensity on T1WI and hypointensity on T2WI or mixed intensity after HIFU treatment. The enhanced values within tumor tissues on dynamic enhanced MRI post-sonication showed a significant decrease or disappearance comparing to pre-sonication. The serum tumor signs decreased and symptoms alleviated post-sonication. Neither significant abnormality of main organs function including heart,liver and kidney nor local serious complication in which adjacent organs damage was observed post-sonication.Conclusion The use of HIFU in the treatment of hepatic carcinoma is effective,feasible and safe. It is a new noninvasive technique for treatment of hepatic carcinoma.