超声造影在肝肿瘤定性及射频消融治疗效果的评价

目的 探讨超声造影在肝肿瘤发现及定性诊断的价值及肿瘤射频消融治疗后疗效的评价.方法 对20例肝肿瘤患者行超声造影检查,观察病灶灌注及各时相强化特点,判断肿瘤性质并与增强MRI进行比较;对超声造影/增强MRI高度怀疑恶性的24个病灶,穿刺活检后射频消融治疗,消融术后2周对消融灶行二维及超声造影检查,并与同期增强MRI检查结果进行比较.结果 二维及彩色多普勒超声发现瘤节结28个,超声造影发现瘤节结36个(增生结节12个,恶性病灶24个),增强MRI发现瘤节结35个(增生结节13个,恶性病灶22个),病理(良性3个,恶性21个);二维超声与超声造影在检测肿瘤数目间差异有统计学意义(P＜0.05);超声造影与增强MRI在测量肿瘤大小及检出肿瘤数间差异无统计学意义(P＞0.05);以穿刺活检为标准,超声造影与增强MRI间比较差异无统计学意义(P＞0.05).结论 超声造影可以实时、有效显示肝肿瘤血管和血流灌注情况,对肝肿瘤定性诊断及评估肝肿瘤射频消融疗效果有较大的应用价值.     

胶质瘤的超声造影实验研究

目的 探讨超声造影评价胶质瘤血供及微波消融疗效的应用价值。方法 建立20只Wistar大鼠皮下胶质瘤模型，随机分为治疗组（10只）、对照组（10只），治疗组给予微波消融（30W、40s），对照组仅置入微波天线。术前20只均行常规超声及超声造影检查；治疗组术后以能量多普勒超声及超声造影评价疗效，并与病理结果对照。结果 造影后能量多普勒超声检测胶质瘤血流分级明显高于造影前（P〈0．05）。实时超声造影可清晰显示胶质瘤的滋养血管，动态观察微循环灌注及定量分析血流灌注参数。微波消融术后能量多普勒超声检查9只未见血流信号，超声造影显示8只部分增强，病理证实10只均消融不全，超声造影与病理符合率显著高于能量多普勒超声（P〈O．05）。结论 造影后能量多普勒超声检测低速血流优于造影前。实时超声造影能动态显示胶质瘤的微循环灌注及准确评价微波消融术后近期疗效。     

超声引导下近胆囊旁肝癌的微波消融治疗分析

目的分析超声引导下应用微波消融治疗近胆囊旁肝癌的效果及临床价值。方法选择2009年1月至2012年12月于就诊本科室的近胆囊旁肝癌患者65例为观察组,病灶共65个,选择同期位于肝实质内的肝癌患者50例为对照组,病灶共55个。均行超声引导下微波消融术治疗,统计消融结果。持续随访3~24个月,观察肿瘤的灭活情况及术后并发症。结果两组消融效果均较好,一次消融成功率、辐射时间等均无显著性差异（P ＞0.05）。观察组术后复查,4个病灶局部肿瘤进展,其发生率6.15%（4/65）,疗后3个月,肿瘤完全坏死率89.2%（58/65）;对照组局部肿瘤进展发生率9.09%（5/55）,肿瘤完全坏死率94.5%（52/55）,两组对比,差异无统计学意义（P ＞0.05）。随访期间所有患者均未出现明显并发症,仅部分患者出现发热、腹痛等症状,未经特殊处理,自然消退,其中观察组并发症发生率69.23%（45/65）,对照组发生率76.00%（38/50）,组间差异亦无统计学意义（P＜ 0.05）。结论超声引导微波消融术治疗近胆囊旁肝癌疗效确切,安全性高,具备临床推广价值。     

超声造影、磁共振评价肾射频消融短期效果的实验研究

目的 应用超声造影(CEUS)、磁共振(MRI)观察正常兔肾射频消融灶的影像表现,并与大体病理进行对照,探讨超声造影、MRI在正常肾射频消融效果评估中的价值.方法 10只新西兰大白兔行肾经皮射频消融术,分别在射频术后1d、1周行超声造影及MRI检查,并与大体标本消融灶的测量结果进行比较.结果 在射频消融术后较短时间内(术后1d和1周),超声造影和增强MRI可以清晰地显示肾消融灶的部位、形态及范围,影像表现与大体标本、超声造影与增强MRI测量结果比较,差异均无统计学意义(P＞0.05).结论 超声造影和增强MRI均适用于肾射频消融灶短期情况的观察评价,超声造影可以实时动态地显示消融灶血流灌注的变化.     

部分特殊部位肝恶性肿瘤的超声引导下冷循环射频消融治疗

目的探讨特殊部位肝恶性肿瘤超声引导下经皮射频消融治疗的安全性、有效性及布针技巧。方法回顾分析2001年11月至2004年8月行超声引导下经皮冷循环射频治疗肝恶性肿瘤患者112例的资料，比较其中46例52个位于胆囊旁、包膜下、肝门部大血管旁等较特殊位置及66例86个非上述特殊部位肿瘤消融治疗的副作用及疗效。结果46例特殊部位肝肿瘤射频消融治疗均顺利进行，未发生严重的并发症，但局部肝周积液（17.4％）和胆囊壁水肿（19．6％）发生率高于非特殊部位组（P=0．0246，P=0．0009）；术后1个月复查甲胎蛋白，甲胎蛋白的变化两组比较差异无显著性意义（P〉0．05）；术后3个月CT复查完全消融41个，局部残留10个，部分消融1个，与非特殊部位组比较差异无显著性意义（P〉0．05）。结论靠近胆囊、肝包膜及肝门部等特殊部位的肿瘤并不是行冷循环射频治疗的禁忌证，只要进针点和路径选择合理，它仍然是一种有效的治疗方法。     

低频超声联合微泡辐照增大对犬前列腺增生组织射频消融灶体积的影响

目的评估低频超声辐照犬前列腺增生组织对射频消融灶大小的影响。 方法实验犬共9只,分为3组（每组各3只）,对犬前列腺行射频消融术,实验组消融术前行低频超声辐照,对照组仅行射频消融术或仅行低频超声辐照;术后即刻行经直肠前列腺常规超声检查、超声造影及磁共振增强检查。低频超声辐照加射频消融组与仅行射频消融术的对照组的增强磁共振成像前列腺消融灶体积的比较采用t检验,低频辐照前造影剂达峰时间、曲线下面积与低频辐照比较采用配对t检验。 结果低频超声辐照后即刻超声造影显示,前列腺内造影剂达峰时间缩短,最大强度较辐照前减低,且造影剂持续时间变长,辐照后造影剂达峰时间由（28.55±10.88）s缩短至（14.81±5.15）s,差异有统计学意义（t=2.796,P=0.0189）,时间-信号强度曲线曲线下面积由（2046.56±424.66）dB s缩小至（1454.82±458.12）dB s,差异有统计学意义（t=2.32,P=0.0427）。超声造影及增强磁共振均能准确评价前列腺射频消融灶大小。实验组消融后磁共振增强图像显示实验组消融灶体积为（1.27±0.21）cm³,仅行射频消融术的对照组消融灶体积为（0.73±0.18）cm³,差异有统计学意义（t=3.382,P=0.0277）;而仅行低频超声辐照的犬前列腺未出现消融灶。 结论低频超声联合微泡辐照能有效阻断增生前列腺组织内血流灌注量,联合射频消融治疗能有效增大消融灶体积。     

腹腔镜胆囊切除术96例超声造影评估

目的 探讨超声造影对拟行胆囊腹腔镜切除术患者周围粘连情况的评估.方法 对96例拟行胆囊腹腔镜切除术患者行超声造影检查,观察其造影表现,与术中情况对比分析.结果 72例患者进行了腹腔镜手术,6例患者进行了开腹手术.术中与术前造影提示符合77例(98.71％).结论 超声造影能够准确提示胆囊壁与周围组织粘连情况.     

CEUS联合MRI实时融合导航技术在评估肝癌消融疗效中的临床应用

目的 探索超声造影联合MRI融合导航技术在评估肝癌消融疗效的临床应用价值。方法 前瞻性纳入三家临床中心自2020年9月至2022年12月行消融的肝细胞肝癌（HCC）患者,随机分为超声造影（CEUS）组和CEUS联合MRI导航组,分别于术前1天及术后30天行超声造影或CEUS联合MRI导航检查。以术后30天普美显增强MRI为标准,判断是否达到安全边界及是否完全消融。结果 本多中心研究最终纳入CEUS组46例患者,46个病灶,CEUS联合MRI导航组31例患者,31个病灶。77个病灶中,27例行射频消融治疗,50例行微波消融治疗。CEUS组46例病灶中,14例未达到安全边界,CEUS联合MRI导航组31例病灶中,4例未达到安全边界,两组无显著差异（P = 0.063）。位于特殊位置（距离肝包膜、大血管旁、胆囊旁、膈肌小于5mm）的病灶中,CEUS组有6例未达到安全边界（6/29）,CEUS联合MRI导航组有2例未达到安全边界（2/17）（P < 0.001）。等回声或边界不清的病灶中,CEUS组有5例未达到安全边界（5/25）,CEUS联合MRI导航组有2例未达到安全边界（2/18）（P < 0.001）。结论 CEUS联合MRI融合导航技术有助于准确判断肝癌消融后的安全边界,尤其是位于特殊位置的病灶及等回声或边界不清的病灶。     

三维超声融合成像可视化技术在引导肝细胞癌热消融精准布针中的初步应用

目的初步探索三维超声融合成像(3DUS FI)可视化技术在引导肝细胞癌(HCC)热消融术中精准布针的临床价值。方法回顾性分析2019年11月至2021年12月于中山大学附属第一医院行3DUS FI引导下热消融治疗的56例HCC患者(59个病灶)。术前采集患者三维超声容积图像并与实时二维超声图像融合配准, 将肿瘤及5 mm安全边界分割标记出来后在三维可视化下进行术前规划并实时引导热消融。术后1个月行增强CT/MRI评估病灶是否消融完全并测量消融边界, 分析消融边界与局部肿瘤进展(LTP)发生率的关系。结果所有病灶术中均可成功配准并三维显示。术后超声造影显示所有病灶均达到完全消融。共有37个病灶可依据术后1个月增强CT/MRI评估消融效果和消融边界, 其中32个(86.5%)病灶达到完全消融且消融边界≥ 5 mm。随访期间, 4个病灶发生LTP, 其中3个发生在消融边界<5 mm处, 所有病灶1年和2年的累积LTP率均为7.1%。所有患者均未发生与热消融治疗相关的严重并发症以及死亡事件。结论 3DUS FI可视化技术引导HCC热消融术中精准布针是可行并且安全的。     

健康教育对超声引导微波消融治疗肝脏肿瘤患者的实施效果

目的：探讨健康教育超声引导微波消融治疗肝脏肿瘤患者的实施效果。方法选取采用超声引导下微波消融治疗的肝脏肿瘤患者84例,随机分为干预组和对照组,每组42例。本组患者均在超声引导下微波消融治疗,对照组患者按肝脏肿瘤及简单的术中常规健康教育,对干预组患者进行微波消融治疗的术前、术中、术后健康教育。采用问卷调查患者超声引导下热消融术相关知识知晓情况,患者对超声引导下热消融术操作过程、焦虑程度、满意度及并发症发生情况。结果干预组患者相关知识平均得分为明显高于对照组（P＜0.01）,患者满意度明显高于对照组（P＜0.01）,焦虑程度明显低于对照组（P＜0.01）。患者术后肝功受损、肝区疼痛、发热及其他的并发症发生率明显低于对照组（ P＜0.05）。结论对微波消融治疗的肝脏肿瘤患者术前、术中、术后进行健康教育能够提高患者相关知识知晓程度,降低患者焦虑程度,减少并发症发生率,对手术顺利完成具有重要意义。     

Differential Diagnosis of Gallbladder Wall Thickening: The Usefulness of Contrast-Enhanced Ultrasound

The purpose of this study was to evaluate the usefulness of contrast-enhanced ultrasound (CEUS) in the differential diagnosis of gallbladder wall (GBW) thickening and determine the predictors of malignant GBW thickening. One hundred fifty-nine patients with GBW thickening, including 76 men and 83 women, from eight institutions were enrolled. CEUS was performed after injection of a sulfur hexafluoride microbubble-based ultrasound contrast agent. Multiple logistic regression analysis was used to reveal independent predictors associated with malignant GBW thickening. The final diagnoses were 48 gallbladder carcinomas and 111 benign gallbladder diseases. Maximal thicknesses of the GBW in malignant and benign GBW thickening were 17.3 ± 5.2 (6–30) mm and 8.6 ± 5.1 (4–26) mm respectively (p < 0.001). CEUS revealed significant differences in intra-lesional vessels, enhancement homogeneity, time to hypo-enhancement, inner layer discontinuity, outer layer discontinuity and adjacent liver involvement (all p-values < 0.05) between malignant and benign GBW thickening. Patient age > 46.5 y, focal GBW thickening, inner layer discontinuity and outer layer discontinuity were found to be associated with malignancy by multiple logistic regression analysis (all p-values < 0.05). Receiver operating characteristic curve analysis revealed Az values for patient age, focal GBW thickening, inner wall discontinuity and outer wall discontinuity of 0.709 (95% confidence interval [CI]: 0.627–0.790), 0.714 (95% CI: 0.630–0.798), 0.860 (95% CI: 0.791–0.928) and 0.858 (95% CI: 0.783–0.933), respectively. CEUS is useful in the differential diagnosis between malignant and benign GBW thickening. Focal GBW thickening, inner wall discontinuity and outer wall discontinuity observed on CEUS are diagnostic clues for malignant GBW thickening.     

超声造影对肝转移癌射频消融的应用价值

目的 探讨超声造影(CEUS)在射频消融(RFA)治疗肝转移癌中的应用价值.方法 141例经临床及病理确诊并拟行RFA的肝转移癌患者,其中102例行CEUS检查,86例被确定符合RFA适应证(A组)为研究对象;同期RFA前未行CEUS检查的39例定为对照组(B组).根据造影灌注特征及病灶数目、大小、形态、浸润范围、位置、与周围结构关系等确定RFA适应证并制定方案进行治疗;B组根据常规超声及CT或MR诊断结果治疗.结果 102例CEUS后计16例确定为非RFA适应证,其中3例10个灶经6～10个疗程化疗后显示病灶内或周边无强化征象,考虑无活性;13例造影后显示病灶浸润范围大于8 cm或多于7个灶或紧邻膈顶、第二肝门等部位并分界不清等.A组中36例(41.9%)病灶增多1～3个(计58灶),大小约8～15 mm,其中79.4%(46/58个灶)仅在实质期显示,共计86例209个灶行RFA治疗;造影后49.7%(75/151灶)显示较原病灶范围增大,其中69.3%(52/75灶)在动脉期增强范围增大,30.7%(23/75灶)在廓清时弱回声范围增大,增大范围均被消融治疗.经1～3个月增强CT随访,肿瘤灭活率A组为94.7%(198/209),B组为87.6%(99/113);2～17个月局部复发A组为7.1%(15/209),B组为14.1%(16/113);A组37.2%(32/86例)出现新生转移灶,B组为43.5%(17/39例);两组灭活率及复发率差异均有统计学意义.结论 超声造影可为射频治疗肝转移癌适应证的选择和治疗范围的确定提供参考依据,从而有效提高疗效并降低复发率,是RFA治疗肝转移癌重要的辅助方法.     

超声造影在胆囊癌诊断中的应用价值

目的 探讨超声造影对胆囊癌的诊断价值.方法 回顾分析经手术病理证实的24例胆囊癌的超声造影表现.结果 胆囊癌的超声造影具有一定的强化特点,24例胆囊癌均可见造影增强,病灶较常规超声显影清晰,采用时间-强度曲线分析可以发现病变部位曲线上升支较为陡直,病变峰值强度高于同水平面上相邻肝组织.10例厚壁型胆囊癌中9例胆囊壁快速明显强化,1例胆囊壁在整个造影过程中呈弱增强,增厚的胆囊壁内可见增粗扭曲的血管;8例肿块型胆囊癌快速整体不均匀增强;6例结节型胆囊癌结节内可见造影剂快速进入,不均匀增强.5例胆囊癌伴肝转移造影后检出更多的转移病灶.结论 超声造影强化特征对胆囊癌的诊断有重要的价值,有助于提高胆囊癌的诊断水平.     

Contrast‐enhanced ultrasound examination of the gallbladder and bile ducts: A pictorial essay

The gallbladder and bile ducts are usually assessed initially with conventional gray‐scale ultrasound (US). Contrast enhanced US (CEUS) is used when a diagnosis cannot be reached with conventional US. CEUS is easy to learn and perform. US contrast agents can be safely administered in patients with renal function impairment. In this pictorial essay the physics, examination technique and indications of CEUS for examining the gallbladder and bile ducts are reviewed. Gallbladder indications include elucidating normal variants, differentiating sludge from neoplastic lesions, benign and malignant pathology, infection, wall rupture and hemobilia. In the biliary tree CEUS is used for studying benign and malignant tumors, including metastases and cholangiocarcinoma, as well as intrabiliary injection.     

超声造影在经皮微波消融治疗子宫肌层良性病变围手术期中的作用

目的 探讨超声造影在经皮微波消融治疗子宫肌层良性病变围手术期中的应用价值.方法 采用微波消融治疗仪对22例患者24个子宫肌层良性病灶(子宫肌壁间、黏膜下和浆膜下肌瘤16个、弥漫性和局限性腺肌病病灶8个)进行微波消融治疗.微波治疗前、治疗后即刻和治疗后12~24 h均行超声造影,观察消融灶增强表现,并对无造影剂灌注区体积进行测量.结果 22例患者微波治疗前后超声造影图像特征:微波治疗前,14例子宫肌瘤16个病灶呈周边强化方式,8例腺肌病8个病灶快速优先增强,峰值时病灶与周围肌层分界不清晰.微波消融后即刻,超声造影显示24个消融灶呈边缘毛糙的类球形或不规则形无增强区,内可见线状、片状热场未消散所致的高增强.微波消融后12~24 h内再次造影,19个消融灶显示为边界较锐利、均匀一致的无增强.微波消融后即刻超声造影显示无造影剂灌注区体积为(83.41±72.83)cm3,小于微波消融后12~24 h的(94.73±80.37)cm3,但差异无统计学意义(t=1.138,P=0.267).结论 在子宫肌瘤和子宫腺肌病经皮微波消融治疗术前及术后超声造影显示微波消融区图像变化特点鲜明,消融治疗后12~24 h内再次超声造影检查可较准确判断治疗后消融灶坏死范围.     

超声造影对直径≥1.0 cm胆囊息肉样病变的鉴别诊断价值

目的探讨超声造影对直径≥1.0 cm的胆囊息肉样病变的鉴别诊断。 方法选取2014年5月至2015年12月在解放军总医院就诊的胆囊息肉样病变患者106例,息肉直径≥1.0 cm。患者于术前行胆囊息肉样病变超声造影检查,记录造影动态图像。造影图像分析由2位医师采用盲法完成。根据手术病理结果将研究对象分为肿瘤性息肉组与非肿瘤性息肉组。2组间年龄、息肉直径、息肉基底部宽度等采用t检验;2组间性别,息肉数目、回声、部位及血流情况、胆囊结石、息肉血管形态,增强模式及程度,胆囊壁完整性等计数资料采用χ²检验,多变量的回归分析采用Logistic回归统计方法。 结果肿瘤性息肉组与非肿瘤性息肉组组间息肉最大直径及彩色血流情况比较,差异均有统计学意义（t=-5.714,χ²=17.609,P均<0.01）。2组间在息肉基底部宽度,点状及分支样血管形态、增强程度、胆囊壁结构完整性方面比较,差异均有统计学意义（χ²=12.527、15.502、22.403、15.403,P均<0.01）。多因素回归分析结果表明,息肉基底部宽度、分支型血管结构是诊断肿瘤性息肉的独立风险因素。超声造影鉴别诊断胆囊肿瘤性息肉与非肿瘤性息肉的敏感度及特异度分别为86.4%、91.7%,阳性预测值为73.1%,阴性预测值为96.3%,诊断符合率90.6%。 结论对于直径≥1.0 cm的胆囊息肉样病变,超声造影在鉴别肿瘤性息肉与非肿瘤性息肉有较高的临床应用价值,有助于临床医生选择合适的治疗方法。     

Ultrasound and Contrast-enhanced Ultrasound Findings after Percutaneous Irreversible Electroporation of Hepatic Malignant Tumors

The aim of this study was to describe ultrasound (US) and contrast-enhanced ultrasound (CEUS) findings immediately and 1 d after percutaneous irreversible electroporation (IRE) of hepatic malignant tumors. Immediately after IRE, the ablation zone was shown to be a gradually expanding hypo-echoic area around the electrodes. The microcirculation of the ablation zone was markedly reduced on CEUS (before vs. immediately after, p < 0.001), and the macrocirculation within the ablation zone was preserved. At 1 d after IRE, the ablation zones lost their hypo-echogenicity to become iso-echoic or hyper-echoic (before vs. 1 d after, p = 0.004; immediately after vs. 1 d after, p = 0.002). At this time, further elimination of microcirculation was confirmed on CEUS (before vs. 1 d after, p < 0.001; immediately after vs. 1 d after, p = 0.003). The size of the ablation zone, which measured by US, was strongly correlated with that measured by CEUS (length: r: = 0.929, width: r = 0.940, p < 0.001), was significantly enlarged immediately after IRE and shrunk 1 d after IRE.     

Characteristic Blood-Perfusion Reduction of Walker 256 Tumor Induced by Diagnostic Ultrasound and Microbubbles

Tumor angiogenesis is characterized by a defective, leaky and fragile microvascular construction, and microbubble-enhanced ultrasound (MEUS) with high-pressure amplitude is capable of disrupting tumor microvasculature and arresting blood perfusion. In this study, we tried to investigate whether the blood perfusion of a malignant tumor can be characteristically interrupted by combining microbubbles and diagnostic ultrasound (US). Twenty-nine Sprague-Dawley (SD) rats with subcutaneous Walker 256 tumors and seven healthy SD rats were included. Fifteen tumors were treated by MEUS, which combined constant microbubble injection and 20 episodes of irradiation by diagnostic US (i.e., acoustic radiation force impulse [ARFI] imaging). The other 14 tumors were treated by ARFI or sham US only. Seven skeleton muscles from healthy SD rats were also treated with MEUS, serving as the control. Contrast-enhanced ultrasound (CEUS) was performed before and after all treatments. The blood perfusion of the tumor MEUS group showed a significant drop immediately after treatment, followed by a quick, incomplete perfusion recovery within 10–20 min. The visual perfusion scoring result was consistent with the quantitative analysis by CEUS peak intensity. However, there were no significant perfusion changes in the tumor control groups or the muscle control group. Histologic examination found severe microvascular disruption and hemorrhage in the MEUS-treated tumors but not in the control groups. Therefore, the treatment combining diagnostic US and microbubbles can specifically decrease or interrupt the blood perfusion of Walker 256 tumors, which could be a potential new imaging method for diagnosing malignant tumors.     

Gallbladder metastasis: spectrum of imaging findings

The objective of this study is to report the diagnostic features of hematogenous gallbladder metastasis using various imaging modalities. We carried out a single-center retrospective analysis of 13 patients with gallbladder metastasis. The primary malignancy was cutaneous melanoma (11 cases), hepatocellular carcinoma (1 case), and non-Hodgkin lymphoma (1 case). All patients underwent sonography (US), with color-power-Doppler assessment in 11 cases. Contrast-enhanced US (CEUS) was performed in 8 patients, MDCT in 8, and MR imaging in 1. Four subjects studied by whole-body PET. The gallbladder lesions were first detected with US in 9 cases and with MDCT in 3 cases. The remaining patient was investigated because of hepatic fluorodeoxyglucose uptake at PET; CEUS failed to detect any liver metastasis in this subject but identified a gallbladder lesion. Typical findings included multiplicity of gallbladder vegetations, broad base, limited mural thickening, presence of contrast enhancement, absence of gallstones and gallbladder bed infiltration, presence of combined lesions within other organs. Only two patients presented an isolated location in the gallbladder and were successfully treated with surgery. Gallbladder metastasis is a rare but possible occurrence. Knowledge of the typical imaging features and careful evaluation of the gallbladder may avoid an incorrect or false negative diagnosis.     

Can the Entire Ablative Hyperechoic Zone be Regarded as a Necrotic Lesion After Radiofrequency Ablation of the Liver?

Developments in image fusion technology made it possible to visualize the ablative margin on ultrasound (US). The purpose of the present study was to assess the ablative area of radiofrequency ablation for hepatocellular carcinoma and compare it with the ablative hyperechoic zone with a non-enhanced area on contrast-enhanced US/contrast-enhanced computed tomography (CEUS/CECT) in the same cross-section. This retrospective study included 25 patients with 27 hepatocellular carcinomas. The long and short dimensions of the ablative hyperechoic zone were measured using B-mode US, and those of the non-enhanced area were assessed with CEUS/CECT on the same cross-section measured with B-mode US, using image fusion techniques. The technical effectiveness of ablation with an adequate ablative margin in a single session was determined in all patients. The long and short dimensions of the ablative hyperechoic zone ranged between 15.0 and 40.7 mm (mean: 27.3 ± 6.9 mm) and between 14.0 and 33.0 mm (mean: 23.3 ± 5.8 mm), respectively. R values for the long and short dimensions were 0.99 and 0.98, respectively, between B-mode US and CEUS, and 0.96 and 0.92, respectively, between B-mode US and CECT. The ablative hyperechoic zone may be regarded as a necrotic lesion after radiofrequency ablation.