实时超声造影在肝癌射频消融治疗效果评价中的应用研究

目的：探讨肝癌射频消融（radiofrequency ablation,RFA）后实时超声造影（contrast-enhanced ultrasound,CEUS）对判断治疗效果的临床应用价值。方法：对经RFA治疗的205例肝癌患者205个病灶术后1个月分别进行常规超声和低机械指数（MI〈1.0）CEUS检查（造影剂为SonoVue）,比较分析常规超声与CEUS在评价肝癌射频消融效果及局部复发中的应用价值。所有患者均同期行增强CT或增强MRI检查。结果：常规超声检查提示92个病灶（44.9%）周边出现低回声区,或于病灶局部检及血流信号,常规超声判断消融不全或局部复发的敏感性为77.5%,特异性为76%;CEUS检查提示80个病灶（39.0%）于动脉期可见造影剂局部充填,CEUS判断消融不全或局部复发的敏感性为97.5%,特异性为98.4%。结论：与常规超声比较,CEUS可以更准确判断RFA术后消融程度及局部复发情况,与增强CT/MRI相当,可为射频治疗术后疗效的判断提供可靠的影像学依据。

Clinical application of real-time contrast-enhanced ultrasonography for liver cancer assessment after radiofrequency ablation

Objective：To investigate the clinical value of real-time contrast-enhanced ultrasonography（CEUS） in evaluating the therapeutic efficacy of radiofrequency ablation（RFA） for liver tumor. Methods： 205 lesions of 205 HCC patients were examined by both conventional ultrasound and real-time CEUS（ SonoVue,MI 〈 0. 1） one month after RFA. Differences between conventional ultrasound and CEUS were compared in evaluating the therapeutic efficacy and local recurrence. All lesions were confirmed by contrast-enhance CT or MRI scan at the same time. Results： Conventional ultrasound found low echo areas around or blood inflows inside 92 lesions（44.9 %）. The sensitivity and specifity of conventional ultrasound were 77. 5% and 76% respectively. CEUS found that 80 lesions（39%） presented partial contrast enhancement on arterial phase. The sensitivity and specifity of conventional ultrasound were 97. 5% and 98. 4% respectively. Conclusion： CEUS is more accurate in identifying the completeness of ablation and local recurrence after RFA,providing a reliable modality in evaluating the therapeutic efficacy as contrast-enhanced CT or MRI.