摘要
目的探讨原发性肝癌及肝转移癌局部治疗后超声造影表现及超声造影在局部治疗后对肝内残留和复发灶的诊断价值。方法采用射频消融(RFA)、经皮无水乙醇注射(PEI)、高强度聚焦超声(HIFU)及肝动脉内灌注化疗及栓塞(TACE)4种治疗方法对114例原发性肝癌(96例)及肝转移癌(18例)患者共计119个病灶进行局部治疗,并于治疗后行超声造影检查及分型:(1)结节增强型;(2)团块增强型;(3)环状增强型;(4)不规则增强型;(5)退出型及;(6)无增强型。依据超声造影分型诊断结果对原发性肝癌或肝转移癌病灶治疗后有无灭活、复发或残留进行评价以指导进一步消融治疗。结果以无增强型作为肿瘤灭活诊断标准,以结节增强型、团块增强型、环状增强型、不规则增强型及退出型作为残留复发的诊断标准,超声造影诊断的敏感性98.1%、特异性92.4%、准确性94.9%、阳性预测值91.2%及阴性预测值为98.4%。结论6种超声造影分型表现对原发性肝癌及肝转移癌局部治疗后残留或复发灶的诊断具有重要临床应用价值。
Objective To explore contrast-enhanced uhrasonography （CEUS） after local treatment of primary hepatic carcinoma and hepatic metastasis and to evaluate diagnostic value of CEUS for residual and recurrent viable tumor at the site of local treatment. Methods A total of 114 patients with 119 tumors （including 96 primary hepatic carcinoma and 18 metastases） were treated with radiofrequeney ablation （RFA）, pcrcutaneous ethanol injection（PEI）, high intensity focused ultrasound （HIFU） and transcatheter arterial chemoembolization（TACE）. The CEUS was applied after local treatment and classified representation of CEUS into 6 categories of patterns ： （ 1 ） nodular enhancement, （ 2 ） mass-like enhancement, （ 3 ） ringlike enhancement, （4） irregular enhancement, （ 5 ） washing out and （ 6 ） non-enhancement. Then diagnostic value of 6 categories of CEUS patterns was analyzed to differentiate residual and recurrent viable tumors from treated areas. Results In 119 tumors, the sensitivity （98. 1% ）, speciality （92. 4% ）, accuracy （94.9%）, positive predictive value （91.2%） and negative predictive value （98.4%） were obtained for CEUS with pattern （ 1 ） - （5）as diagnostic criteria of viable tumor and pattern（6 ）as that of treated inactive area. Conclusions The CEUS with 6 categories of patterns play an important role for differentiating viable tumors from treated inactive areas after local treatment of primary hepatic carcinoma and hepatic metastasis.
出处
《中华医学超声杂志（电子版）》
2009年第1期14-18,共5页
Chinese Journal of Medical Ultrasound(Electronic Edition)
基金
北京市科技计划课题重大项目培育专项(Z0005190040431)
北京市卫生局青年科学研究基金(QN2007-22)
关键词
超声检查
造影剂
肝肿瘤
局部治疗
Uhrasonography
Contrast media
Liver neoplasms
Local therapy
