术中CEUS与MRI评价肝肿瘤微波消融早期疗效的应用

目的 探讨术中超声造影（contrast-enhanced ultrasound,CEUS）与同期MRI在肝肿瘤微波消融术后早期（术后24h内）疗效的评价价值.方法 41例患者49个病灶微波消融后行术中CEUS及同期（6～24h）MRI检查,明确消融范围,发现肿瘤残存及时补救消融,与随访结果对照观察评价准确性.结果 术中CEUS及同期MRI判断消融疗效符合率分别为91.8％ （45/49）和95.9％ （47/49）,对肝肿瘤消融早期疗效评价及消融后病灶变化范围的比较,二者差异无统计学意义（P＞0.05）.结论 术中CEUS及同期MRI均可准确地判断微波消融后肿瘤灭活程度及微波消融范围,二者联合应用是微波消融术后早期疗效评价的有效方法.

Intraoperative CEUS and synchronal MRI in evaluating the early curative effect of microwave ablation of liver tumors

Objective To discuss the value of intraoperative contrast enhanced ultrasound （CEUS） and synchronal MRI in evaluating the curative effect of percutaneous microwave ablation in patients with hepatic tumor so as to increase the inactivated rate in a relatively short period of treatment.Methods 49 tumors in 41patients were performed CEUS examination（10～ 30 min）using SonoVue by venous injection to observe the microwave ablation curative effect.When the suspected lesion was identified,further ablation was performed immediately.Compared the last CEUS and synchronization MRI （6 ～24h）,the ablation effect was evalueated.If any suspected lesion was found,further ablation would be performed within 48 hours.All the cases were followed-up by CEUS,CECT/CE MRI and clinical examination after 1～12 months.Results There was well consistency in investigating curative effect between intraoperative CEUS and synchronal MRI with the coincidence of 91.8％ （45/49） and 95.9％ （47/49） respectively.There was no significant difference in evaluating the curative effect and assessment of treatment extent （P ＞0.05）.Conclusion Both intraoperative CEUS and MRI can detect the deactivation degree and evaluate the treatment extent of microwave ablation accurately.However,each of them owns its advantages.The combination of CEUS and MRI is proved to be the effective imaging modalities for detection and assessment of post-treatment effect of microwave ablation.