二维及多普勒超声观察射频治疗兔VX2肝肿瘤早期疗效的实验研究

目的　评价超声在观察集束电极射频治疗兔VX2 肝肿瘤早期疗效中的作用。方法　超声引导下将 2 5只大白兔建立VX2 肝肿瘤模型 ,随机抽取 5只作为对照组 ,其余 2 0只作为治疗组进行射频治疗 ,分别于治疗前 1d和治疗后当日 ,3d ,7d及 14d对肿瘤形态学及血流动力学变化进行超声观察。在治疗后每次超声检测结束处死 5只大白兔 ,取肿瘤标本进行病理检查。结果　肿瘤射频治疗后 ,治疗区呈极不均匀斑点状强回声及低回声 ,瘤内血流信号全部消失 ,部分肿块瘤周局部区域仍有血流信号。治疗后肿块未见明显长大 ,治疗组肿块治疗后 14d明显小于相应时间对照组肿块 (P <0 .0 1)。病理证实极不均匀回声及血流信号消失区域即为肿瘤组织凝固坏死区域 ,局部仍有术前肿瘤回声特点及血流信号存在的区域即为残存肿瘤或治疗不完全的区域。结论　兔VX2 肝肿瘤射频治疗后凝固坏死区具有一定的声像图特异性表现 ,结合彩色多普勒血流显像及能量多普勒超声 ,对肝肿瘤疗效观察确切可行。

Experimental study of early-term curative effect observation of radio frequency ablation to VX2 tumor in rabbit liver using two-dimensional and Doppler ultrasonography

Objective To evaluate two-dimensional, color Doppler flow imaging (CDFI) and color Doppler energy (CDE) ultrasound examination in observing the early-term curative effect of radio frequency (RF) ablation to VX 2 tumor in rabbit liver.Methods Models of VX 2 liver tumors of 25 rabbits were established and were divided into two groups in random. There were 20 in treating group which treated with US-guided RF ablation, the other 5 in control group. Morphological and hemodynamic features were investigated 1 day before treatment, as well as the day after treatment and 3 days, 7 days and 14 days later, respectively,using two-dimensional, CDFI and CDE. Five rabbits of the treatment group were killed each time and tumors were sent for pathologic studies.Results Foci of inhomogeneous spot-like hyperecho and hypoecho were seen after treatment. No blood flow was seen within tumors but in part of peritumors. Tumors tended to decrease 14 days after therapy. Foci of inhomogeneous and blood flow disappearing area were coagulated and necrosis tumors, foci of remaining blood flow and characters as before treatment were residual tumors, both of which were confirmed by pathology.Conclusions There are certain features for coagulation and necrosis of VX 2 tumor on ultrasonography after RF therapy, which is exact and reliable to the observation of curative effects when combining with CDFI and CDE.