彩色多普勒血流显像对集束电极射频治疗肝癌的效果观察

目的;利用彩色多普勒显像技术评价肝癌集束电极射频治疗术的早期效果。方法：采用彩色多普勒血流显像仪对２８例肝癌患者,集束电极射频治疗术前后１周肿瘤内血流动力学变化进行观察。结果：集束电极射频治疗前２８例肝癌患者３８个结节中３１个可测及血流信号,以动脉脉混合血流供血为主,治疗后有血流的３１个肿块中１１个血流减少,１４个完全消失,肿瘤内Ⅱ￣Ⅲ级血供及动静脉双重供血明显减少,早期观察认为血流减少或消失与肿     

集束电极射频治疗肝癌38例体会

目的：探讨集束电极射频治疗肝癌的疗效及并发症。方法：B超引导下经皮肝穿将集束电极置入肿瘤内,然后发生射频波,使肿瘤局部产生100－120℃的温度从而毁损肿瘤细胞,术后检测肝功能及AFP,并观察CT／MRI及B超的改变。结果：术后肝功能改变不明显,86．2％患AFP下降,其中51．7％降至正常。CT／MRI均显示肿瘤细胞坏死,84．2％的患肿块直径近期缩小大于1CM,但远期观察无明显进步缩小,不良反应发生率为52．6％,无一例围手术期死亡。结论：集束电极射频治疗肝癌创伤小,疗效可靠,但有一定的并发症,应严格掌握适应症。     

超声显像及多普勒技术在肝癌射频治疗中的应用

目的利用超声显像引导肝癌射频治疗,结合彩色及能量多普勒评价其治疗效果。方法对120例肝癌患者射频治疗前后1周肿瘤内血供及形态学变化进行观察,并对部分病例术后1个月进行超声检测。结果120例肝癌患者167个肿块术后瘤体缩小103个(61%),血流信号消失116个(79%),肝动脉峰值流速明显降低(89.5±36.0cm/svs63.6±26.0cm/sP<0.01)。1月后对39例患者复查,31例瘤体不同程度缩小,瘤体内无血流信号;3例再次出现血流信号。结论超声显像及多普勒技术不但能准确地引导肝癌射频治疗,而且对判断疗效及指导再次治疗具有重要意义。     

彩色多普勒超声对集束电极射频治疗肝癌的疗效观察

目的　利用彩色多普勒超声评价肝癌集束电极射频 (RFA)治疗的效果。方法　对 12例肝癌患者射频治疗术前后 1周肿块的大小及血流动力学的变化进行观察。结果　射频治疗术后 1周 ,12例患者 2 3个肿块中 ,14个肿块体积缩小 ,6个肿块大小变化不明显 ,3个肿块较术前增大。低回声肿块变成高回声 ,强回声肿块不变或变成不均质强回声。术前18个肿块可测及血流信号 ,术后 8个肿块血流信号减少 ,6个肿块血流信号完全消失 ,4个无明显变化。结论　彩色多普勒超声对肝癌射频治疗前后肿块大小及血流变化的观察可以为预后判断和重复治疗提供依据     

超声引导经皮射频微创治疗原发性肝癌90例报告

肝癌是我国常见的恶性肿瘤，并且预后较差，中晚期肝癌往往手术无法切除，采用全身化疗、介入、栓塞等治疗方法效果也不满意。近年来，经皮射频消融（PRFA）在肝癌治疗中得到广泛的应用，已经成为肝癌治疗的一个新的重要手段。我院肝胆胰腺外科和超声科合作把PRFA集中应用原发性肝癌的非手术微创治疗中，取得了较为理想的疗效。现报告如下。     

超声引导下多电极射频治疗原发性肝癌

目的探讨超声引导下多电极射频疗法对原发性肝癌的治疗效果。方法在超声引导下,对５４例原发性肝癌患者行多极射频治疗,观察治疗前后肿瘤声像图表现、大小、血流频谱、ＡＥＰ水平及生存率变化。结果多电极射频治疗后,肿瘤区由术前等或低或略高回声转变强弱不等点状回声,术后１～２周４６例病灶内动静脉血流频谱几乎消失。术后２～６周３８例ＡＦＰ阳性患者转阴３１例,下降４例,有效率９２．１％。术后３个月复查超声或ＣＴ显示     

超声引导经皮射频微创治疗原发性肝癌90例报告

肝癌是我国常见的恶性肿瘤,并且预后较差,中晚期肝癌往往手术无法切除,采用全身化疗、介入、栓塞等治疗方法效果也不满意。近年来,经皮射频消融(PRFA)在肝癌治疗中得到广泛的应用,已经成为肝癌治疗的一个新的重要手段。我院肝胆胰腺外科和超声科合作把PRFA集中应用原发性肝癌的     

超声引导下射频消融治疗肝癌的临床价值

目的：探讨超声引导下多极射频介入治疗肝癌的临床价值。方法：19例肝癌患者26枚结节在超声引导下进行射频消融治疗，采取由深到浅，多点多部位，重叠消融的治疗原因，结果：12个结节（46．2％）缩小，肿瘤回声均增强16个（61．5％）血流信号减少或消失；病检8例阴性（8／12）；10例甲胎蛋白下降（10／13）；7例（7／13）肝功能改善，结论：超声引导下多电极射频治疗肝癌是一种疗效确切，操作简便，损伤小，安全性高的有效方法。     

超声引导下多电极射频消融治疗原发性肝癌的临床价值

目前 ,超声引导射频技术无疑是一种有效的治疗肝脏肿瘤的新方法 ,射频消融治疗具有操作简便 ,定位准确 ,定时监测 ,创伤小 ,疗效好 ,毒副作用轻等优点 ,为微创治疗肝癌提供了一种可选择的方法。随着技术的改进 ,设备的更新以及临床经验的积累 ,射频治疗术将可更有效地治疗较大肝癌肿瘤。观察术前后肝癌血供状态 ,声像图变化提供主要依据 ,对指导治疗判定疗效有着重要意义。我院于 2 0 0 2年 5月至今在超声引导下用多电极射频消融治疗肝癌 15例 ,疗效显著 ,现报告如下 :1　资料与方法1.1　临床资料 :肝癌患者 15例 ,年龄 40～ 65岁 ,男 10例 …     

集束电极射频热凝治疗肝癌的护理128例

肝癌是最常见的恶性肿瘤之一，年病死率位居恶性肿瘤的第2位，目前手术切除仍是肝癌的主要治疗方法。但多数肝癌病人，当确诊时，限于肿瘤的位置、大小、多病灶及其肝功能储备、全身情况无法耐受手术等原因，根治性切除已不可能进行，射频热凝技术被认为是目前治疗无法手术切除肝癌的较     

应用自然组织谐波和彩色多普勒血流显像技术评价集束电极射频治疗肝癌的早期效果

目的 ＮＴＨＩ及ＣＤＦＩ评价肝部射频治疗术早期效果。方法 应用ＮＴＨＩ和ＣＤＦＩ对行集束电极射频治疗肝癌的３５例患者４７个肿块治疗前后１周瘤体的形态学及血供进行观察。结果 射频术后１周,３５例患者４７个肿块中３１个体积缩小,９个 块大小变化不明显,７个肿块较术前增大。低回声肿块变成等回声或强问声肿块,强回声肿块无变化或变化不均质强回声。术前４２个肿块可测及血流信号,术后１９个血流减少,１４个完全消     

应用自然组织谐波和彩色多普勒血流显像技术评价集束电极射频治疗肝癌的早期效果

目的 NTHI 及CDFI 评价肝癌射频治疗术早期效果。方法 应用NTHI 和CDFI 对行集束电极射频治 疗肝癌的35 例患者47 个肿块治疗前后1 周瘤体的形态学及血供进行了观察。结果 射频术后1 周,35 例患者47 个肿块中31 个体积缩小,9 个肿块大小变化不明显,7 个肿块较术前增大。低回声肿块变成等回声或强回声肿块, 强回声肿块无变化或变化不均质强回声。术前42 个肿块可测及血流信号,术后19 个血流减少,14 个完全消失。结论 NTHI 和CDFI 对观察射频疗效有重要的意义。     

Impact of Microbubble-Enhanced Ultrasound on Liver Ethanol Ablation

Ethanol ablation (EA) is a safe and effective method for treating small liver cancer. However, the ethanol is rapidly washed out by blood perfusion, preventing its accumulation within tumors. Microbubble-enhanced ultrasound (MEUS) is capable of disrupting tumor and liver circulation. We hypothesized that this disruption could be used to enhance EA of normal liver tissue. We treated surgically exposed rabbit liver with a combination of MEUS and EA. The controls were treated with only MEUS or 0.05 mL EA. MEUS treatment was administered with a high-pressure-amplitude, pulsed therapeutic ultrasound device and intra-venous injection of microbubbles. Therapeutic ultrasound was delivered at an acoustic pressure of 4.3 MPa and a duty cycle of 0.22%. Contrast-enhanced ultrasound was performed to estimate liver blood perfusion. Livers were harvested for necrotic volume measurements 48 h after treatment. Contrast-enhanced ultrasound demonstrated that liver perfusion was temporally arrested, with a significant peak intensity decline from −46.9 ± 3.8 to −64.0 ± 3.3 dB, after MEUS treatment. The mean volume ablated in MEUS + EA-treated livers (3.3 ± 2.3 cm³) was more than 10 times larger than that in livers treated only with EA (0.3 ± 0.2 cm³). The volume of liver ablated by MEUS treatment alone was minor, scattered and immeasurable. These results indicate that MEUS disruption of the liver circulation can greatly promote EA of liver.     

Effect of Microbubble-Enhanced Ultrasound on Radiofrequency Ablation of Rabbit Liver

Microbubble-enhanced ultrasound (MEUS) can non-invasively disrupt and block liver blood perfusion. It may potentially overcome the heat sink effect during a thermal ablation and consequently enhance radiofrequency ablation (RFA) of the liver. We propose a new strategy combining RFA with MEUS. For ultrasound treatment, an 831-kHz air-backed focused transducer directed 400-cycle bursts at 4.3?MPa to the liver at a 9-Hz rate. The treatment was nucleated by a lipids microbubble forming MEUS. Eighteen surgically exposed rabbit livers were treated using MEUS combined with RFA; the other 32 livers were treated using MEUS (n?=?14) or RFA (n?=?18) alone and served as the controls. Contrast ultrasound imaging confirmed that MEUS treatment significantly reduced liver blood perfusion by cutting contrast peak intensities in half (44.7%–54.1%) without severe liver function damage. The ablated liver volume treated using MEUS combined with RFA was 2.8 times greater than that treated using RFA alone. In conclusion, RFA of the liver can be safely and greatly enhanced by combination with MEUS pre-treatment.     

Synergistic Ablation of Liver Tissue and Liver Cancer Cells with High-Intensity Focused Ultrasound and Ethanol

We investigated the combined effect of ethanol and high-intensity focused ultrasound (HIFU), first, on heating and cavitation bubble activity in tissue-mimicking phantoms and porcine liver tissues and, second, on the viability of HepG2 liver cancer cells. Phantoms or porcine tissues were injected with ethanol and then subjected to HIFU at acoustic power ranging from 1.2 to 20.5 W (HIFU levels 1–7). Cavitation events and the temperature around the focal zone were measured with a passive cavitation detector and embedded type K thermocouples, respectively. HepG2 cells were subjected to 4% ethanol solution in growth medium (v/v) just before the cells were exposed to HIFU at 2.7, 8.7 or 12.0 W for 30 s. Cell viability was measured 2, 24 and 72 h post-treatment. The results indicate that ethanol and HIFU have a synergistic effect on liver cancer ablation as manifested by greater temperature rise and lesion volume in liver tissues and reduced viability of liver cancer cells. This effect is likely caused by reduction of the cavitation threshold in the presence of ethanol and the increased rate of ethanol diffusion through the cell membrane caused by HIFU-induced streaming, sonoporation and heating.     

多弹头射频治疗肝癌的护理

多弹头射频肝癌治疗系统是目前国际上先进而有效的治疗手段。具有不需开刀、创伤性小、疗时短、住院时间短、疗效满意的优点,积极完善术前项准备工作,加强术中监护,防止和肮时处理术后并发症,是保证治疗成功的关键,文中具体介绍了术前、术中及术后的护理。     

Image-Guided Non-Invasive Ultrasound Liver Ablation Using Histotripsy: Feasibility Study in an In Vivo Porcine Model

Hepatocellular carcinoma (HCC), or liver cancer, is one of the fastest growing cancers in the United States. Current liver ablation methods are thermal based and share limitations resulting from the heat sink effect of blood flow through the highly vascular liver. In this study, we explore the feasibility of using histotripsy for non-invasive liver ablation in the treatment of liver cancer. Histotripsy is a non-thermal ablation method that fractionates soft tissue through the control of acoustic cavitation. Twelve histotripsy lesions ∼1 cm³ were created in the livers of six pigs through an intact abdomen and chest in vivo. Histotripsy pulses of 10 cycles, 500-Hz pulse repetition frequency (PRF), and 14- to 17-MPa estimated in situ peak negative pressure were applied to the liver using a 1-MHz therapy transducer. Treatments were performed through 4–6 cm of overlying tissue, with 30%–50% of the ultrasound pathway covered by the rib cage. Complete fractionation of liver parenchyma was observed, with sharp boundaries after 16.7-min treatments. In addition, two larger volumes of 18 and 60 cm³ were generated within 60 min in two additional pigs. As major vessels and gallbladder have higher mechanical strength and are more resistant to histotripsy, these remained intact while the liver surrounding these structures was completely fractionated. This work shows that histotripsy is capable of non-invasively fractionating liver tissue while preserving critical anatomic structures within the liver. Results suggest histotripsy has potential for the non-invasive ablation of liver tumors.     

超声对肝癌、肝硬化患者腹腔动脉的血流动力学探讨

目的探讨肝癌、肝硬化患者腹腔动脉的血流动力学改变。方法对190例正常人、94例肝硬化合并肝癌、87例肝硬化患者运用灰阶、彩色多普勒、脉冲多普勒超声检查腹腔动脉内径、最高流速、最低流速、平均流速、阻力指数和血流量。结果肝硬化患者腹腔动脉的血流量较正常人明显增加,肝硬化合并肝癌患者腹腔动脉的血流量较肝硬化患者高。结论腹腔动脉血流动力学的改变,可为诊断肝癌、肝硬化提供参考信息。