超声造影对氩氦刀治疗肝癌近期临床疗效的评价

目的 了解超声造影对氩氦刀治疗肝癌近期临床疗效评价的应用价值.方法 选取23例共26个肝癌病灶为观察对象.采用第二代新型对比剂SonoVue以及CPS(Contrast Pluse Sequencing)造影软件.全部病灶氩氦刀治疗后1周至3个月采用超声造影,评价治疗效果,并与常规超声和增强CT或MRI检查结果进行比较.结果 氩氦刀治疗后超声造影显示20个治疗区各期均无异常增强,判断肿瘤完全灭活;5个病灶局部有早期增强,提示有肿瘤残存;1枚可疑残存肿瘤.超声造影显示11枚新生病灶,较常规超声增加8枚,其中肿瘤直径≤1 cm的微小病灶6枚.1例微小复发灶超声造影未能显示,以最终诊断为金标准.超声造影诊断准确率为96.1%,与增强CT或MRI检查结果相同.结论 超声造影可较准确地判断氩氦刀治疗后肿瘤灭活程度,是评价氩氦刀疗效的一种有效方法,并有助于发现微小新病灶.

Evaluation of enhanced ultrasonography for hepatic carcinoma with cryosurgery

Objective To evaluate the role of enhanced ultrasonography in assessing the short term therapeutic response of hepatic carcinoma with cryosurgery.Methods Twenty three patients with 26 lesions were enrolled in the study with contrast agent SonoVue and CPS software technology for evaluation the therapeutic response in all the patients one week and three months after cryosurgery.Simultaneously,all patients underwent routine US,CT and MRI for comparison.Results After cryosurgery,twenty lesions showed no enhancement within entire procedural periods,which indicated complete necrosis.Five lesions showed local enhancement in arterial phase suggesting tumor residue and another as the suspected.Eleven new lesions were found by enhanced ultrasonography with eight more than offered by conventional ultrasonography,including six smaller than 10 mm in diameter and another small recurrent lesion was not demonstrated.According to the final diagnosis as gold standard,the accuracy was 96.1% for enhanced ultrasonography,which was equivalent to the enhanced CT or MRI.Conclusions Enhanced ultrasonography can accurately differentiate tumor necrosis and evaluate therapeutic efficacy of cryosurgery.It is also useful to identify minute foci early after the ablation.(J Intervent Radiol,2007,16:246-248)