利声显在超声导向植入式微波留置固化治疗肝癌时 的血管定位和疗效判断价值

目的，探讨在超声导向植入式微波留置固治疗肝癌时，应用利声显作血管树定位和治疗后判断疗效的价值。方法 28例肝癌，作44例次微波凝固治疗，治疗前应用利声显超声造影，显示肿瘤内血管树，以血管树主干作为凝固治疗的重点，治疗后再次利声超声造影，观察肿瘤内血流变化，判断疗效，结果 44例次均清晰显示肿瘤内血管树主，并以此作为凝固治疗的重点，经复查随访肿瘤区内未发现血流，结论 以利声显超声造影显示的血管树主干作为凝固治疗的重点，经复查随访肿瘤区内均未发现血流，结论 以利声显超声造影显示的血管树主干作为凝固治疗的重点，可提高疗效，建议将利声显造影多普勒检查作为判断微波凝固治疗疗效的金标准。     

超声引导下经皮经肝穿刺微波凝固治疗肝癌的临床研究

目的　在实时超声引导下将微波天线直接插入人体肝脏肿瘤 ,产生凝固坏死 (PMCT)。评价该方法在治疗肝脏肿瘤中的价值。方法　应用HSE 8M微波治疗仪 (频率 2 45 0MHz)对 3 2例患者的 5 1个肝癌结节进行微波凝固治疗 ,并用Levovist(利声显 )超声造影、3 DUS和实验室检查等观察疗效。结果　微波凝固治疗后 ,Levovist造影显示肿瘤内血流消失或明显减少 ,3 2例中有 2 0例原发性肝癌 ,其中 16例AFP明显下降 ,一例下降近 3万单位 ,无严重并发症 ,临床疗效较满意。结论　PMCT可使肿瘤留置固化、原位灭活 ,是一种安全、有效、副作用小、可供选择的肝癌非手术治疗方法 ;将肿瘤内血管树主干作为凝固治疗的主要目标 ,可提高疗效 ;Levovist造影观察PMCT前后肝脏肿瘤内血流的变化应当作为判断PMCT疗效的金标准 ;3 DUS成像可以非常直观地观察凝固区形态 ,准确测量凝固区体积 ,客观评价疗效。     

利声显增强显像观察TAE治疗肝癌效果

目的：用超声造影剂利声显增强显像, 观察原发性肝癌逆行肝动脉插管栓塞化疗（ＴＡＥ）前后肿瘤图像的彩色多普勒信号变化。方法： 使用ＨＰＳｏｎｏｓ ２５００型彩超仪, 探头频率２．５ＭＨｚ, 仪器检查条件一致, 对２０例原发性肝癌患者于ＴＡＥ治疗前和治疗后５～７日内各检查１次, 每次检查使用１支利声显, 增强结果用两种方法评价。结果： ＴＡＥ治疗前, 肿瘤血供丰富, 利声显增强效果明显; ＴＡＥ治疗后, 肿瘤血供减少, 尽管利声显增强效果确实,彩色信号仍明显减弱。计算机数字化显示ＴＡＥ治疗前利声显增强前后肿瘤内彩色点的百分比值为５．１９±４．８５Ｖｓ ２６．５２±１５．８３, ＴＡＥ治疗后利声显增强前后肿瘤内彩色点的百分比值为１．４２±１．１１ Ｖｓ１０．２７±７．３８。结论： 利声显对肝癌肿瘤的彩色多普勒信号具有确实的增强效果; ＴＡＥ治疗后, 肝癌肿瘤彩色多普勒信号明显减少; 用计算机分析利声显的增强效果, 结果更加直观、可靠, 对判断ＴＡＥ疗效具有实际的临床价值和意义。     

应用利声显对彩色多普勒超声诊断肾肿瘤的意义—附30例报告

目的：评价声学造影剂利声显（levovist,SHU 508A)对彩色多普勒超声诊断肾肿瘤的价值。方法：30例肾肿瘤病人在注射利声显前后分别用彩色多普勒超声进行检查,其中肾透明细胞癌20例,肾盂癌1例,肾转移癌1例,肾血管平滑肌脂肪瘤7例,肾腺瘤1例。用计算机测量造影前后肾肿瘤的单位面积血流值（BFAR值）,比较造影前后病灶内血流情况。结果：造影后的BFAR值较造影前明显增强,超过25％者26例（87％）,界于10％至25％（轻度增强）者3例（10％）,造影后BFAR值显著高于造影前（P＜0．01）;造影后血流信号增强持续时间在肾恶性肿瘤长于肾良性肿瘤,有显著性差异;造影后瘤内血流信号分布、形态均有改变。结论：应用利声显能显著增强肾肿瘤的彩色多普勒超声血流信号,从而有助于准确地评价肾肿瘤的血液供应,有利于对肾肿瘤的诊断与鉴别诊断。     

利声显超声造影在超声导向微波凝固治疗中的应用

利声显(Levovist)超声造影能增强二维、彩色和频谱超声多普勒信号强度,改善低速血流的彩色多普勒血流显像,为研究组织的血流灌注提供了有力的手段。本研究将对利声显超声造影应用于超声导向微波凝固治疗肿瘤和疾病鉴别诊断作一探索。 资料与方法 本组18例,男13例、女5例;年龄30～70岁,平均年龄50.61岁;进行了32例次利声显超声造影。其中经过超声、CT等检查,临床诊断肝肿瘤患者15例、转移性肺癌1例、肾癌1例、胰腺肿瘤1例。拟进行利声显超声造影和超声导向活组织检查,进一步确诊后,作超声导向微波肿瘤凝固治疗。仪器为ACUSON 128XP10/ART,TCR电脑声像仪,探头频率4MHz。超声造影剂为德国先灵公司生产的利声显,浓度为300mg/ml,每次1支,经肘静脉推注时间为30至60秒。造影前用二维超声纪录肿瘤大小、内部回声;彩色多普勒血流图和能量图观察瘤内及瘤周血流情况和频谱。注射造影剂后观察血流信号增强情况、增强时间等。整个过程采用SONY AG 7350E高保真录像机和TOMTEC P90图像工作站同步纪录,进行脱机分析。造影过程中心电图全程监护并作为R波触发。     

彩色多普勒血流显像评价肾癌的血管性——一种新的超声造影剂的应用价值

目的：评价超声造影剂利声显对彩超检测肾细胞癌血流状况的增强效应,并探讨其临床应用价值。资料与方法：应用彩色多普勒血流显像检查１９例（个）肾细胞癌,均经手术病理证实,经周围静脉注射超声造影剂利声显（ＳＨＵ５０８Ａ）,浓度３００ｍｇ／ｍｌ,平均注射剂量７９ｍｌ。观察注射前后瘤内血流信号显像情况。结果：超声造影前１９个肾癌彩超显示４个无血流信号,１１个周边部分环绕血流,４个瘤周瘤内见散在点状、短条状血流;超声造影后,１９个肾癌瘤内血流信号均增强,１６／１９（８４．２１％）明显增强,３／１９（１５．７９％）轻度增强,增强效应主要表现为血流信号明显增多,分布区域增大,血管显示段延长,分枝更清晰完整。结论：超声造影剂利声显能显著增强肾细胞癌内彩色多普勒血流信号,更完整显示肾癌的血管形态、分布等,明显改善彩超对肾癌血供的评价,对肾肿瘤诊断有重要的临床应用价值。     

利声显对肝、肾、子宫肿瘤血流信号增强作用的研究

目的　评价利声显对肝、肾、子宫肿瘤彩色多普勒信号的增强作用。方法　对３５ 例原发性肝癌、５ 例继发性肝癌、３ 例肝血管瘤、１ 例肝硬化结节、３ 例肾癌、３ 例子宫肌瘤进行研究。将７ ｍｌ 浓度为３００ ｍｇ／ｍｌ 的利声显由外周静脉注入,观察肿瘤彩色多普勒信号增强程度及脏器实质区图像。结果　３２ 例原发性肝癌和１ 例较大的胆囊转移性肝癌的彩色多普勒信号明显增强,肝血管瘤的略增强,肝硬化结节的无增强,肾癌和子宫肌瘤的增强均好,且实质区图像改善,于４ 例原发性肝癌患者的肝区内又探及新的小病灶。结论　利声显对肝、肾、子宫肿瘤的血流信号均有增强作用,它对判断肿瘤的血供情况、分析肿瘤的病理性质,提高超声诊断的敏感性很有益处。     

心电R波显像在利声显超声造影中的应用研究

本文介绍在利声显超声造影诊断肝脏肿瘤时 ,应用心电Ｒ波显像技术 ,分析肿瘤内显示的血管时相 ,为鉴别肿瘤的良恶性提供依据。1　资料和方法本组 2 0例 ,年龄 2 5～ 70岁 ,平均年龄 5 1.0 5岁。男 17例 ,女 3例。临床分别诊断为 :肝癌 17例、转移性肺癌 1例、肾癌 1例和胰腺癌 1例 ,拟作超声导向肿瘤微波凝固治疗。治疗前作二维超声、彩色多普勒血流图、彩色多普勒能量图检查、利声显超声造影和超声导向肝活组织检查。仪器为ＡＣＵＳＯＮ12 8ＸＰ10 /ＡＲＴ ,ＴＣＲ电脑声像仪 ,探头频率 4ＭＨｚ。心电显像采用随机心电图装置 ,连接心前导联…     

利声显超声造影在超声导向微波凝固治疗肿瘤前的应用研究

目的;评价在超声导向微波凝固治疗肿瘤前作利声显超声造影的鉴别诊断价值。方法：20例临床诊断为恶性肿瘤的患者,经周围静脉注射利声显作超声造影和超声导向经皮穿刺活组织检查,作对照分析。结果：20例中12例确诊为肝癌、1例为转移性肺癌,7例确诊为良性病变。恶性病变造影后病灶区血管增强为2-3级、呈动脉相或混合相增强图像、时间-强度曲线呈高抛型;良性病变病灶区血管增强为0-1级、呈静脉朴增强图像、时间-强度曲线呈低平型。结论：利声显超声造影对超声导向微波凝固治疗前,肿瘤良恶性的鉴别诊断有显著价值。     

利声显对肝肿瘤血流信号和肝实质区回声增强作用的研究

目的:评价新型利声显对不同肝肿瘤的彩色多普勒信号和肝实质区回声的增强作用。材料和方法:肝肿瘤患者共44例,其中原发性肝癌35例、继发性肝癌5例、肝血管瘤3例、肝硬化结节1例。使用HP Sonos 2500型彩超仪,控头频率2.5MHz。将利声显稀释为浓度为300mg/ml的溶液,由外周静脉注入,持续观察肿瘤彩色多普勒信号增强程度及肝脏实质区回声。结果:彩色多普勒信号增强情况为:32例原发性肝癌和1例较大胆囊转移癌明显增强,3例原发性小结节型肝癌、4例转移性结节性肝癌、2例肝血管瘤轻度增强,肝硬化结节无增强。肝实质区图像清晰度改善,于4例原发性肝癌患者的肝区内又测及新的小病灶。结论:利声显可增强肝肿瘤的血流信号,且不同肝肿瘤的增强程度有差异。它对判断肿瘤的血供情况、初步分析肿瘤的病理性质,提高超声诊断的敏感性很有益处。     

The diagnostic value of levovist in Doppler imaging of visceral arteries in patients with abdominal angina before and after angioplasty

PURPOSE: To assess the diagnostic value of Levovist in the ultrasound imaging of visceral arteries in patients with clinical symptoms of abdominal angina, before and after percutaneous transluminal angioplasty (PTA). MATERIAL AND METHOD: During a 12-month period (2000/2001) five patients with visceral arterial stenoses had ultrasound examinations and a subsequent PTA procedure. Indications for ultrasound examination were abdominal angina symptoms persisting for 3-5 years, (postprandial abdominal pain, diarrhea, and vomiting). In all patients ultrasound examinations were performed using color and spectral Doppler before and after Levovist injections. Color Doppler images and maximum blood flow velocity in stenosed visceral arteries were assessed. Patients underwent control Doppler examinations with Levovist injections to assess the effect of PTA. RESULTS: In three patients conventional Doppler examination did not allow proper evaluation of visceral arteries, because of weak color and spectral Doppler signal and in two remaining patients visceral arteries were not visualized at all. In all five patients strong enhancement of color and spectral Doppler signal was observed after Levovist administration. In all these cases a hemodynamically significant stenosis was diagnosed: coeliac trunk-2 and superior mesenteric artery-3. PTA was performed successfully in these patients. In one of them ultrasound examination done before Levovist injection allowed good visualization of treated SMA and showed good PTA result. In the remaining four patients Doppler examination with the use of Levovist demonstrated visceral arteries well and confirmed successful PTA procedures. CONCLUSIONS: The use of Levovist makes the diagnostic efficiency of Doppler examinations much higher. In most cases it allows an unequivocal diagnosis of visceral artery stenosis in patients with abdominal angina symptoms. The Doppler examination with the use of Levovist is the method of choice in follow-up after PTA.     

Levovist超声造影在肝癌疗效判断中的临床价值

目的：研究Levovist彩色多普勒超声造影对肝癌疗效判断的作用。方法：对接受过介入治疗的24个肝癌病灶进行CDFI超声造影，病灶直径1～10cm，平均3．3cm。造影剂采用Levovist(Schering AG，Berlin，Germany)。结果：24例治疗后的肝癌瘤内血流显示率由造影前的29．1％(7／24)提高至造影后的58．3％(14／24)，肿瘤内血流信号强度分级在造影后也有提高。5个病灶做了治疗前后的超声造影对比。对于造影后2例显示有瘤内血流的病灶，又追加了PEIT治疗。结论：CDFI超声造影可以提高肿瘤内血流信号检测，反映肿瘤坏死情况或有无复发，指导治疗方案的选择和制定。     

CT引导下经皮穿刺微波消融联合~（125）I粒子植入治疗肝癌的术后护理

目的总结肝癌患者经皮穿刺微波消融联合125I放射性粒子植入术术后护理要点。方法对34例肝癌患者行CT引导下经皮穿刺微波消融联合125I放射性粒子植入术,并配合做好术后护理工作。结果本组患者完全缓解（CR）6例,部分缓解（PR）24例,稳定（SD）4例,总有效率为88.2%。术后并发症：发热6例、肝区疼痛7例、呕心、呕吐4例、穿刺点伤口感染1例、胸腔积液1例、穿刺部位出血1例。结论 CT引导下经皮穿刺微波消融联合125I粒子植入治疗肝癌效果较好,术后做好患者病情观察与并发症护理是治疗成功的重要措施。     

彩色多普勒超声造影诊断肝内小占位性病变的临床研究

目的　研究经周围静脉彩色多普勒超声造影在肝内小占位性病变的鉴别诊断中的作用和意义。方法　选择 <3cm的肝内占位性病变 5 4个进行超声造影检查。其中良性病变 2 0个 (血管瘤 9个 ,局灶性结节性增生 3个 ,炎性假瘤 4个 ,术后疤痕 1个 ,肝硬化结节 3个 ) ;恶性病变 3 4个 (肝细胞肝癌 3 1个 ,肝腺瘤样增生癌变 1个 ,胃癌及结肠癌肝转移各 1个 )。造影剂采用Levovist ,剂量 2 .5g ,浓度 40 0mg/ml。结果　良性病变造影前后血流显示率分别为 3 0 % (6/2 0 )和 40 % (8/2 0 ) (P >0 .0 5 ) ;肝癌造影前后血流显示率分别为 5 3 % (18/3 4)和 94% (3 2 /3 4) (P <0 .0 1) ,造影后血流显示明显提高。结论　Levovist造影后 ,肝内病灶血流信号得到明显增强 ,彩色多普勒血流显像充分显示了肿瘤内血流分布状况 ,有利于克服肿瘤大小及深度对血流显示率的影响 ,提高小肝癌的诊断符合率     

Contrast-enhanced color Doppler sonography of uveal melanomas

PURPOSE: The purpose of our study was to evaluate the use of the galactose microbubble-based contrast agent Levovist in color Doppler sonography of uveal melanomas. We also evaluated the use of the resistance index and pulsatility index in differentiating tumor-associated vessels from normal vessels in patients with uveal melanomas. METHODS: In this prospective study, 40 patients with uveal melanoma were examined with color Doppler sonography before and after the administration of the contrast agent Levovist. The Doppler signals were recorded from both the tumor and the orbit and were evaluated quantitatively and qualitatively. RESULTS: Tumor-associated vessels were detected without contrast enhancement in 36 of 40 patients and with contrast enhancement in 38 of 40 patients. The spectral characteristics of the Doppler signals did not change after the injection of Levovist. There were no differences-qualitative or quantitative-in Doppler signals between normal and tumor-associated vessels. CONCLUSIONS: The injection of Levovist slightly improved the detection of small vessels in uveal melanomas and the orbit but did not help to differentiate between normal vessels and tumoral vessels. The differentiation of a solid tumor from subretinal hemorrhage or effusion was improved.     

Combined use of contrast-enhanced 2-dimensional and color Doppler echocardiography for improved left ventricular endocardial border delineation using Levovist, a new venous echocardiographic contrast agent

Transthoracic echocardiography often provides inadequate endocardial border visualization, particularly of the left ventricular apex. The aim of this study was to determine whether the transpulmonary echocardiographic contrast agent, Levovist, could improve endocardial visualization. Accordingly, 43 patients underwent 2-dimensional echocardiography before and after intravenous administration of Levovist. Definition of the left ventricular septal, apical and lateral borders was graded: 0 = no definition, 1 = partial definition, 2 = complete definition. Color Doppler was performed before and after contrast in 32/43 patients and similarly scored to determine any further benefit in apical border detection. There was significant (p %lt; 0.001) improvement of the average end-diastolic scores of the septal, apical and lateral regions (1.4 %plusmn; 0.5, 0.6 %plusmn; 0.7 and 0.9 %plusmn; 0.5 before and 1.8 %plusmn; 0.4, 1.4 %plusmn; 0.6 and 1.7 %plusmn; 0.5 after Levovist). The average end-systolic score was significantly different (p %lt; 0.001) from end-diastolic values in the apex only (0.3 %plusmn; 0.6 before and 0.8 %plusmn; 0.7 after Levovist). Average apical scores using color Doppler improved from 0.3 %plusmn; 0.6 and 0.1 %plusmn; 0.2 during end-diastole and end-systole to 1.7 %plusmn; 0.5 and 1.2 %plusmn; 0.6, respectively, after Levovist (p %lt; 0.001); the average end-diastolic contrast-enhanced color Doppler score was significantly higher than the corresponding grey scale score (p %lt; 0.001). We conclude that left ventricular endocardial border definition is significantly improved by Levovist. The use of contrast enhanced color Doppler can compensate for limited efficacy of this method in the apex.