超声造影引导经皮穿刺射频消融治疗肝癌肝移植术后肝转移

目的通过临床总结，评价超声造影（CEUS）辅助射频消融（RFA）治疗肝癌肝移植术后肝转移的优点及应用价值。方法采用超声造影辅助定位经皮穿刺RFA治疗肝癌肝移植术后肝转移癌12例，直径1．2—5．5cm，发现病灶时间为肝移植术后3—12个月，每个病灶通过超声造影诊断定位进行RFA1—2次，术后通过超声造影及增强CT评价疗效。结果11例病灶术后两周复查全部消融，1例最大病灶有部分残余行再次RFA，1个月后复查无局部复发。结论超声造影辅助下经皮RFA治疗肝癌肝移植术后肝转移癌，定位准确，效果好，操作简便易行，微创无并发症，可作为肝移植术后肝转移癌的首选治疗。

Percutaneous radiofrequency ablation under contrast-enhanced ultrasonography guidance in treatment of post-transplantation recurrence of hepatocellular carcinoma

Objective To evaluate the advantage and applied value of percutaneous radiofrequency ablation （RFA） under contrast - enhanced ultrasonography （ CEUS ） guidance for the post - transplantation recurrence of hepatocellular carcinoma by clinical analysis. Methods The clinical data of 12 patients with recurrence of hepatocellular carcinoma after liver transplantation treated by percutaneous RFA under CEUS were analyzed. The diameters of all the recurrent tumors varied from 1.2 to 5.5 cm. The length of time between diagnosis and treatment was 3 months to 12 months. Each patient had diagnosis and localiza- tion under CEUS 1 or 2 times. And each had CEUS or contrast CT for estimation of the curative effect after treatment. Results Two weeks after treatment, 11 of the total 12 patients had the recurrent tumor ablated completely. The remaining one with the largest focal received once more RFA owing to partial residual, and 1 month later there was no tumor resident. Conclusion The treatment of percutaneous RFA under CEUS guidance for the post - transplantation recurrence of hepatocellular carcinoma has the advantages of early discovery, accurate localization, easy handling, and minimal invasion without complications. It could be recommended as the preferred therapy for the post - transplantation recurrent tumors.