反向脉冲谐波超声造影显像评价肝恶性肿瘤介入治疗疗效

Liver neoplasms treated with invasive therapies:usefulness of contrast enhancement pulse-inversion harmonic US imaging in evaluating therapeutic response

目的 探讨反向脉冲谐波超声造影显像评价肝恶性肿瘤介入治疗疗效的临床应用价值。方法 对 10例接受介入治疗后的肝恶性肿瘤病灶进行反向脉冲谐波超声造影显像 ,观察病灶的血流灌注 ,并与造影前后病灶的彩色多普勒显像进行对照 ,超声检查后随访 14～ 16个月。结果 应用反向脉冲谐波超声造影显像 ,本组的 10例介入治疗后肝肿瘤灶血流显示率 (60 % )较造影前 (10 % )提高 ,且高于彩色多普勒超声造影显像方式 (4 0 % )。随访发现复发的 4例中 ,反向脉冲谐波超声造影显像均可见血流信号 (10 0 % ) ,彩色多普勒超声造影显像在 2例中 (5 0 % )观察到血流信号 ,而造影前仅在 1例中 (2 5 % )观察到血流信号。结论 反向脉冲谐波超声造影显像对于评估肝恶性肿瘤介入治疗疗效较传统超声显像方法更可靠 ,并有望成为经皮介入治疗的有效辅助工具。

Objective To evaluate the value of pulse-inversion harmonic (PIH) sonographic imaging with a microbubble contrast agent in assessing the therapeutic response of liver neoplasms with invasive therapies. Methods Ten patients with 10 liver neoplasms underwent PIH sonographic imaging after intravenous administration of SonoVue. The enhancement of the tumor were recorded to evaluate the therapeutic response. The results of these studies were compared with those of color Doppler sonographic imaging before and after intravenous administration of SonoVue. These 10 patients were followed up for 14 to 16 months after these procedures. Results After contrast agent administration, flow signals were showed in 60% cases with PIH sonographic imaging. Whereas flow signals were showed in 10% and 40% cases separately with color Doppler sonographic imaging before and after administration. The 4 cases, showed recurrence with follow up, were all (100%) found enhancing foci with contrast enhancement PIH imaging. Only 1 (25%) and 2 (50%) cases were found flow signals separately with nonenhanced and enhanced color Doppler sonographic imaging. Conclusion The results of contrast enhancement PIH sonographic imaging were more reliable than that of conventional sonographic imaging. Preliminary data suggests that contrast enhancement PIH sonographic imaging can be a promising nonvasive technique for assessing therapeutic response.