摘要
目的:探讨超声造影(CEUS)对高强度聚焦超声(HIFU)消融治疗胰腺癌早期疗效评价的应用价值.方法:29例胰腺癌患者于HIFU治疗前1-3d行CEUS检查,观察肿瘤大小、边界及内部血流灌注情况,制定出HIFU治疗计划;治疗后1-3d行CEUS,对比观察HIFU治疗后肿瘤大小、边界及内部血流灌注的改变,判断消融治疗的范围和程度.其中15例患者超声造影结果与核磁共振成像(MRI)检查结果进行比较.结果:29例患者中23例(79.3%)在HIFU治疗前超声造影过程中表现为轻度增强,增强程度低于胰腺实质,6例(20.7%)患者呈等至高增强,造影剂清除早于胰腺实质.HIFU治疗后,29例患者均见肿瘤出现不同程度的无血流灌注区,8例第1次HIFU消融后肿瘤完全无血流灌注;12例第2次HIFU消融治疗后肿瘤内无血流灌注,4例第3次HIFU消融治疗后肿瘤内无血流灌注;5例患者经过3次HIFU消融后边缘仍然有少量血流灌注现象,提示有残留病灶存在,需再次HIFU消融治疗.患者超声造影与MRI检查比较,超声造影在肿瘤灭活诊断中的准确性与MRI相近(86.7%vs93.3%,P>0.05).结论:HIFU对胰腺癌消融治疗后,利用CEUS技术能及时准确地判断出消融的范围和程度,并为HIFU消融胰腺癌早期疗效评价和治疗方案的制定提供了依据.
AIM： To evaluate the role of contrast-enhanced ultrasound （CEUS） in assessing the short-term therapeutic response to high-intensity focused ultrasound （HIFU） in patients with pancreatic car- cinoma. METHODS： Twenty-nine patients with pancre- atic carcinoma received HIFU treatment. CEUS was performed to monitor the response of tumor vessels to HIFU ablation before and after treat- ment. Meanwhile, 15 patients underwent mag- netic resonance imaging （MRI） for comparison. RESULTS： Before treatment, hypoenhancement was found on CEUS in 23 （79.3%） patients, and isoenhancement to hyperenhancement in 6 （20.7%） patients. Contrast agent washout was significantly faster in pancreatic carcinoma le- sions than in normal pancreatic tissue in all cas- es. Complete non-enhancement area was noted in 8 cases after first HIFU therapy, in 12 cases after second therapy, and in 4 cases after third treatment. Five cases presented hypoenhance- ment at the boundary of the lesion even after third treatment and needed more treatments. The accuracy of CEUS was similar to that of MRI in assessing the response to HIFU therapy （86.7% vs 93.3 %, P 〉 0.05）. CONCLUSION： CEUS allows to accurately dif- ferentiate tumor necrosis and evaluate response to HIFU treatment in patients with pancreatic carcinoma.
出处
《世界华人消化杂志》
CAS
北大核心
2011年第2期196-199,共4页
World Chinese Journal of Digestology
关键词
高强度聚焦超声
超声造影
胰腺癌
High-intensity focused ultrasound
Con- trast-enhanced ultrasound
Pancreatic carcinoma
