超声造影在肝癌消融术后的应用价值

肝癌消融术后影像学评价是临床须要解决的重要问题。超声造影技术无创、安全,可获得治疗区域微循环信息。简要介绍超声造影方法、局部及异位复发的表现。当肝消融灶超声造影各时相无增强、无异常廓清,治疗区域呈灌注缺失状态表明消融完全。局部残存活性或复发灶形态多样,常位于病灶周边,以结节状、不规则形增强多见,超声造影动脉期发现异常强化为阳性诊断指标,可以检出大部分活性灶。随访中病灶增大提示肿瘤局部复发或有活性。认为超声造影与增强CT在评价肝肿瘤消融后的价值相近,是可用于疗效判断和随访的影像方法。

Role of contrast enhanced ultrasound in evaluating hepatic malignancies after ablation

Imaging evaluation of hepatic malignancies after ablation is an important clinical problem to be solved.Contrast enhanced ultrasound（CEUS） is a noninvasive,safe technique for acquiring the microcirculation information of treatment areas.The CEUS technique and the findings of local and distant recurrence were reviewed.Complete ablation was defined as follows： the ablation area had neither enhancement nor abnormal wash-out and was presented as perfusion deficiency in each phase of CEUS.Local residual or recurrent tumor had various patterns,and their common location was in the periphery of the lesions,being nodular or in irregular enhancement.The positive indicator of recurrence was that CEUS found abnormal enhancement in arterial phase.Most lesions with viability can be detected by this criteria.During follow-up,local recurrence or viability of tumor should be considered when the lesion was increased in size.Most current studies have demonstrated that CEUS has a similar value as contrast enhanced computed tomography in evaluating hepatic malignancies after ablation and that CEUS offers an imaging option for treatment evaluation and follow-up.