超声造影谐频成像与螺旋CT对肝癌非手术治疗后疗效的评价

目的　评价比较超声造影双向脉冲谐频成像和螺旋CT在判断肝肿瘤治疗效果方面的价值。方法　对经多种非手术治疗后的肝癌患者 72例共 82个肿瘤分别进行超声造影和螺旋CT检查 ,比较两种影像技术的结果。结果　超声造影谐频成像的连续成像和间歇成像可分别显示肝肿瘤的血管影像和血流灌注情况。超声造影显示造影增强者 5 4.9% (4 5 /82 ) ,负性增强者 45 .1% (3 7/82 ) ;螺旋CT显示不完全治愈者 5 3 .7% (4 4 /82 ) ,完全治愈者 40 .2 % (3 3 /82 ) ,其余 6.1% (5 /82 )因碘油沉积而不能明确判断。结论　与螺旋CT相比 ,超声造影揭示治疗后的肿瘤内血流信号的敏感性、特异性和准确性均较高 ;由于超声声像图较少受碘油沉积的影响以及其影像可直接引导进一步的穿刺局部治疗 ,超声造影更适宜于TAE术后肿瘤的疗效判断

Evaluation of Treatment Response in Hepatocellular Carcinoma with Contrast-Enhanced Phase-Inversion Harmonic Imaging and Helical CT

Objective To compare the usefulness of assessing therapeutic effectiveness of hepatic carcinoma (HCC) by contrast enhanced harmonic imaging and helical CT. Methods Seventy two patients with 82 HCC tumors after non surgical treatment were examined with Levovist enhanced Coded Harmonic Angio (CHA) sonography and helical CT,and the results of two modalities were compared. Results Continuous imaging and interval delay imaging of CHA mode depicted tumor vessels and tumor perfusion imaging respectively. Positive enhancement of CHA sonography was found in 54.9% (45/82) HCC,and negative enhancement was in 45.1% (37/82). In contrast,helical CT revealed incomplete treatment in 53.7% (44/82) HCC and complete treatment in 40.2% (37/82). The remain 6.1% (5/82) HCC couldn't be evaluated by helical CT due to the retention of Lipidol. Conclusion Contrast enhanced harmonic imaging can depict tumor vascularity in treated HCC sensitively and accurately when compared with helical CT. Because it is less affected by the retention of Lipidol and provide a real time needle insertion guidance,it may be preferable to perform after localized therapy to monitor treatment response.