摘要
目的:评估SonoVue谐波超声造影即刻判定经皮微波凝固治疗(PMCT)肝细胞癌残余瘤的疗效和用途。材料和方法:53例肝细胞癌患者的55个癌灶(1.3～6.0cm)经皮微波凝固治疗后,经肘部静脉团注射SonoVue,观察癌灶凝固治疗区造影的增强情况。引导临床实施肝细胞癌治疗区穿刺活检,对治疗区局部动态超声增强部位,追加二次PMCT。治疗1周内,全部患者进行增强CT随访,之后,每月随访一次,随访6月。结果:46个无超声动态增强治疗区,其中1个组织病理证实为残余瘤存在。9个治疗区局部呈结节形或新月形动态增强,组织病理学检查证实为残余瘤存在。以病理组织学所见结果为诊断标准,谐波超声造影结果与之比较,其检测肝细胞癌凝固区残余瘤的敏感性、特异性和准确性分别为90%、100%和98.2%。随访增强CT检查,9个补加PMCT肝细胞癌治疗区中,1个显示CT强化。结论:谐波超声造影是一种PMCT肝细胞癌后及时判断治疗效果,并指导临床治疗残余瘤的有效方法。
Purpose To evaluate the utility of contrast-enhanced harmonic ultrasonography with SonoVue in the early assessment of the therapeutic response to percutaneous microwave coagulation therapy（PMCT） for hepatocellular carcinoma. Materials and Methods Fifty-three patients with fifty-five nodular hepatocellular carcinomas （1.3-6.0 cm） treated with PMCT were evaluated with contrast-enhanced harmonic ultrasonography after cubital intravenous bolus injection of SonoVue. Coagulation zones were evaluated with a continuous scan after initiation of SonoVue injection and pathologically punctured with enhanced ultra- sound-guided. The dynamic enhanced coagulation zones were coagulated again. All patients underwent follow-up contrast-enhanced CT within one week after treatment and once per month during the next 6 months after PMCT. Results Forty-six coagulation zones ultra- sonically demonstrated dynamic non-enhancement, one of which was confirmed residual tumors by histopathologic examination. Nine coagulation zones were ultrasonically presented with either nodular or crescentic dynamic enhancing foci, which Add： were residual tumors by histopathologie examination. Compared with histopathologic findings Add： which was set golden standard, the diagnostic sensitivity, specificity and accuracy of contrast-enhanced harmonic ultrasonography for the detection of residual tumor tissue in coagulated tumors were 90%, 100% and 98.2%, respectively. One of nine re-coagulated zones was enhanced on follow-up contrast-enhanced CT. Conclusions Contrast-enhanced harmonic sonography is an effective technique for PMCT post-procedural assessment and guidance of residue therapy.
出处
《中国医学影像学杂志》
CSCD
北大核心
2010年第4期322-324,共3页
Chinese Journal of Medical Imaging
关键词
癌
肝细胞
超声检查
造影剂
微波/治疗应用
carcinoma, hepatocellular
ultrasonography
contrast media
micro waves/therapeutic use
