【摘要】 目的　探讨恶性骨肿瘤行高强度聚焦超声 (HIFU)联合肿瘤供血动脉内灌注化疗和全身化疗的临床和影像学特征。材料与方法　 43例恶性骨肿瘤患者接受HIFU、介入和全身化疗的联合治疗 ,观察临床及影像学变化 ,重点是肿瘤血管造影的好转、变化情况。结果　联合治疗后绝大部分患者临床指标明显改善 ,保肢率为 95 % ( 4 1/43 )。X线、CT检查显示 78.9% ( 3 0 /3 8)的患者肿块变小 ,5例瘤区钙化增加 ;ECT示 79% ( 3 1/3 9)的患者肿瘤局部放射性浓聚减弱、范围缩小 ;DSA随访 2 7例见肿瘤血湖、肿瘤血管网和瘤性血管减少或消失。结论　HIFU、介入和全身化疗的综合治疗是恶性骨肿瘤非手术保肢治疗最新的有效方法。DSA检查在评价骨肿瘤联合治疗疗效及预后的判断中具有重要价值更多还原

【Abstract】 Objective To study the clinical manifestations and imaging features of malignant bone tumors post high intensity focused ultrasound (HIFU) therapy combined with intra arterial infusion and systemic chemotherapy.Materials and Methods Forty three cases with malignant bone tumors were included in this study. The clinical and imaging appearances, especially angiographic features, were observed.Results The clinical symptoms were remarkably improved. The rate of limb salvage was 95% (41/43). On plain films and CT scans, 78.9% (30/38) of tumors decreased in size, calcifications within tumors were seen in 5 cases. On ECT, 79% patients (31/39) showed a reduction in tracer accumulation. Follow up DSA in 27 cases demonstrated reduction or disappearance of the tumorous blood lakes, tumor vessels and tumor vasculature.Conclusion HIFU therapy combined with intra arterial infusion and systemic chemotherapy is an effective, non operative and the state of the art treatment for some malignant bone tumors. DSA is helpful for evaluating curative effect and prognosis.更多还原