肝脏超声造影在原发性肝癌导管栓塞治疗效果评价中的应用研究

目的 通过CPS对TACE治疗中晚期肝癌的观察,了解CPS对TACE疗效的评价作用,并进一步指导TACE的治疗.方法 利用CPS对行TACE治疗的47例中晚期肝癌病人进行造影,观察肿瘤组织血供情况,了解肿瘤组织内部有无残留血供和遗漏病灶.结果 CPS结果提示:(1)单次TACE治疗病例中,病灶血供完全消失病例明显高于多次TACE治疗的病例(P＜0.01),分别为17.39%、8.33%;肿瘤病灶遗漏也明显高于多次TACE治疗的病例(P＜0.01),分别为34.78%、9.33%.(2)在单发病灶病人中,28.57%病人肿瘤血供完全消失,明显高于多发病灶病例(P＜0.01).(3)10例CPS提示的肿瘤遗漏病人均为多发病灶(10/26,38.46%),同时有16例(61.54%)病人为血供残留.结论 CPS能够比较精确地反映TACE治疗后肿瘤血供阻断情况,客观地评价和反映了TACE治疗的疗效.这不仅说明TACE治疗有着自身的局限性和重复治疗的必要性,同时也为进一步寻求新的HCC治疗手段和进行必要的补充治疗提供了依据.

Role of contrast-enhanced sonography in evaluation of TACE for primary HCC

Objective To determine the value of contrast-enhanced sonography(CPS)for evaluating the curative effect of TACE on primary HCC to further guide the performance of TACE.Methods of the 47 cases of HCC treated with TACE in our hospital,CPS was used to evaluate the blood perfusion features of HCC.Results of the 23 cases treated with TACE once,4(17.39%)had no blood perfusion in tumors and 19 had it or omitted neoplasm.Amongst the other 24 cases treated with TACE twice or more,2(8.33%had no blood perfusion,20(83.3%)had it and 2(8.33%)had omitted neoplasm.The number of patients with blood perfusion of tumors and omitted neoplasm was significantly higher in the single-TACE group than in the more-TACE group.For the 21 patients with single lesion of HCC,6(28.5%)had no blood perfusion of the tumor and 15(71.43%)had it.The 10 patients(10/26,38.46%)with omitted neoplasm were with multiple lesions of HCC and the others had blood perfusion of tumors.Conclusion CPS is an effective procedure to evaluate curative effect of TACE on HCC and can be used as a new method tO determine blood supply of tumors.