【摘要】 目的探讨超声造影(CEUS)在原发性肝癌TACE术后残留诊治中的价值。方法对65个经DSA验证的TACE术后残留原发性肝癌(PLC)病灶,行CEUS检查,明确其位置和CEUS特征,指导制定合理的经皮微波消融治疗(PMCT)方案,分析消融疗效并随访其2年生存率。结果 PMCT消融1个月内肿瘤直径未见明显变化,超声造影评估PLC疗效与DSA有很好的一致性;TACE术后残留病灶经PMCT治疗后完全消融率为96. 9%,AFP均有不同程度的降低,术后未见严重并发症;其6个月、1年、1年半和2年的生存率分别为87. 7%、70. 8%、53. 8%和43. 1%。结论 CEUS准确显示了TACE术后PLC残存病灶的血流灌注特征,为准确制定PMCT方案和治疗策略提供了很大的帮助,CEUS和DSA在PLC疗效评估方面有很好的一致性,CEUS逐渐成为PLC消融方案制定和疗效评估不可或缺的影像学方法。更多还原

【Abstract】 Objective To investigate the value of CEUS in the diagnosis and treatment of primary liver cancer after TACE. Methods Sixty-five DSA-confirmed residual PLC lesions after TACE were examined by contrast-enhanced ultrasound and their location and contrast-enhanced characteristics were evaluated. The rational PMCT ablation protocol was established and the 2-year survival rate was analyzed. Results There was no significant changes of tumor size in 1 month after PMCT ablation. The contrast echocardiography was used to evaluate the efficacy of PLC in DSA. The complete ablation rate of residual tumor after TACE was 96. 9%. To some extent,the AFP was decreased and no serious complications were found after operation. The 6-month,1-year,1. 5-year and 2-year survival rates were 87. 7%,70. 8%,53. 8% and 43. 1% respectively. Conclusion CEUS accurately displays the perfusion characteristics of residual PLC after TACE,which provided a great help for the accurate PMCT ablation strategy and treatment strategy. CEUS and DSA have a good consistency in the evaluation of PLC efficacy and CEUS gradually becomes PLC ablation program development and evaluation of the effects of imaging indispensable methods.更多还原