高强度聚焦超声治疗55例原发性肝癌后的早期影像学变化

目的：研究高强度聚焦超声（HIFU）治疗原发性肝癌（PLC）的早期影像学变化，为建立HIFU治疗肝癌的评价标准提供依据。方法：HIFU治疗本组55例PLC病人，观察治疗前后彩色多普勒超声、DSA、CT或MRI的变化。结果：与治疗前比较，经HIFU治疗后1-2周内肝癌出现治疗有效的影像学变化。其中，MRI是评价疗效的最佳检查方法，主要表现为T1和T2加权相信号的变化，以及动态增强相癌灶血液供应消失，边缘出现环状薄层的强化带。结论：MRI能及时判断HIFU是否完全灭活肝癌，治疗区有无残存癌组织和确定治疗范围。

Early image alternations in 55 patients with primary liver cancer treated by high intensity focused ultrasound

ObjectiveTo evaluate the early image alterations of primary liver cancer (PLC) treated by high intensity focused ultrasound (HIFU). MethodsA total of 55 PLC patients underwent extracorporeal HIFU ablation. Color Doppler ultrasound, digital substraction angiography (DSA), computed tomography (CT) or magnetic resonance imaging (MRI) were performed to monitor the therapeutic response.ResultsImage examinations obtained 2 weeks after HIFU ablation showed significant response of PLC. MRI was the best for evaluating HIFU efficacy. Unenhanced MRI revealed signal alterations on both T 1 and T 2 weighted images, and enhanced MRI demonstrated the absence of contrast enhancement in the treated HCC and a thin peripheral rim of enhancement surrounding the coagulation necrosis. ConclusionMRI rapidly assesses HIFU induced complete ablation of HCC, residual viable cancer tissure in treated region, and coagulation extent of HIFU treatment.