超声造影在肝癌TACE术后残留诊治中的价值

目的 探讨超声造影（CEUS）在原发性肝癌TACE术后残留诊治中的价值。方法 对65个经DSA验证的TACE术后残留原发性肝癌（PLC）病灶，行CEUS检查，明确其位置和CEUS特征，指导制定合理的经皮微波消融治疗（PMCT）方案，分析消融疗效并随访其2年生存率。结果 PMCT消融1个月内肿瘤直径未见明显变化，超声造影评估PLC疗效与DSA有很好的一致性；TACE术后残留病灶经PMCT治疗后完全消融率为96.9%，AFP均有不同程度的降低，术后未见严重并发症；其6个月、1年、1年半和2年的生存率分别为87.7%、70.8%、53.8%和43.1%。结论 CEUS准确显示了TACE术后PLC残存病灶的血流灌注特征，为准确制定PMCT方案和治疗策略提供了很大的帮助，CEUS和DSA在PLC疗效评估方面有很好的一致性，CEUS逐渐成为PLC消融方案制定和疗效评估不可或缺的影像学方法。

Value of Contrast-Enhanced Ultrasound in the Residual Diagnosis and Treatment of Primary Liver Cancer after TACE

Objective To investigate the value of CEUS in the diagnosis and treatment of primary liver cancer after TACE. Methods Sixty-five DSA-confirmed residual PLC lesions after TACE were examined by contrast-enhanced ultrasound and their location and contrast-enhanced characteristics were evaluated. The rational PMCT ablation protocol was established and the 2-year survival rate was analyzed. Results There was no significant changes of tumor size in 1 month after PMCT ablation. The contrast echocardiography was used to evaluate the efficacy of PLC in DSA. The complete ablation rate of residual tumor after TACE was 96.9%.To some extent, the AFP was decreased and no serious complications were found after operation. The 6-month, 1-year, 1.5-year and 2-year survival rates were 87.7%, 70.8%, 53.8% and 43.1% respectively. Conclusion CEUS accurately displays the perfusion characteristics of residual PLC after TACE, which provided a great help for the accurate PMCT ablation strategy and treatment strategy. CEUS and DSA have a good consistency in the evaluation of PLC efficacy and CEUS gradually becomes PLC ablation program development and evaluation of the effects of imaging indispensable methods.