【摘要】 目的　探讨造影增强超声在肝肿瘤射频消融 (RFA)治疗前后的应用价值。方法　在 17例原发性肝癌 (HCC)和 1例肝转移癌患者RFA治疗前和治疗后 ,采用超声造影剂SonoVue、TechnosDU6超声仪和CnTI实时造影成像技术进行造影增强超声检查。结果　RFA治疗前 ,造影增强超声观察 2 6个病灶 ,图像记录详细的 2 4个病灶表现为动脉早期抱球状、弥漫或轻度增强 ;9个病灶显示荷瘤血管。 12个病灶有增大趋势 ,其中边界不清及无晕征的病灶各 11个增大较明显。造影后 ,有 4例发现常规超声及CT、MR不能显示的微小卫星灶 13个。RFA治疗后有 2 2个病灶行造影增强超声检查 ,肿瘤灭活诊断正确率为 95 .5 % ,与增强CT检查结果相同。造影增强超声诊断率明显高于常规彩超的6 3.6 % ,两者差异有统计学意义。结论　造影增强超声可以帮助了解患者肝肿瘤的性质、大小、数目和荷瘤血管等信息 ,有助于RFA适应证的选择和治疗方案的制定 ,有助于评价RFA治疗后肿瘤灭活程度。更多还原

【Abstract】 Objective To investigate the clinical value of enhanced ultrasonography before and after ultrasound guided radiofrequency ablation (RFA) of hepatomas. Methods Eighteen patients with 17 primary hepatocellular carcinoma and 1 hepatic metastasis were studied. Sixteen were confirmed by operation or needle puncture biopsy, 2 by clinical examinations including CT scanning,MRI etc. New contrast agent, SonoVue, Technos DU6 and Contrast Tuned Imaging (CnTI) technique were adopted. Enhanced ultrasonography was performed before or after the RFA procedure. Results Twenty six lesions were observed with enhanced ultrasonography before RFA, 24 of which showed ball carrying sign or diffuse enhancement at the early artery phase favoring the fast diagnosis; 9 lesions showed feeding vessels; twelve of the 26 lesions (46.2%) tended to be larger, especially those with unclear margins (78.6%, 11/14) and those without halo sign (68.8%, 11/16). Enhanced ultrasonography revealed 13 satellite foci in four cases which had been undetectable with routine ultrasound, CT scanning or MRI. The final diagnosis of either inactivation or residual disease would rely upon more than two kinds of images,levels of tumor marks, biopsy pathology and more than 7 months of follow up. Twenty two lesions were observed with enhanced ultrasonography after RFA,with an accuracy of 95.5% (21/22),being similar to the enhanced CT and was significantly superior to the routine color ultrasonography whose accuracy was only 63.6% (14/22). Conclusion Enhanced ultrasonography may provide more information on the characters, size, number and feeding vessels of the tumor before radiofrequency ablation, thus helping choose the indicator, establish and carry out the treatment protocol. This technique may also help to assess the therapeutic response to RFA.更多还原