肝脏实时超声造影在肝癌微波消融治疗中的应用

目的 探讨肝脏超声造影在肝癌微波消融治疗中的应用价值。方法 总结我院2008年1月至2012年6月26例微波消融治疗肝癌的病倒资料。微波消融62个病灶；微波消融治疗前、术中和术后均进行肝脏超声造影检查；经皮穿刺肝脏肿瘤微波消融治疗22例，术中B超导向微波消融治疗4例。结果 本组病例消融术后无出血、胆漏、感染等并发症发生，B超CDFI检查判断肝脏肿瘤微波消融后疗效的准确性为64.5%，肝脏CEUS判断准确性为95.2%，差异具有统计学意义（x2=5.241，P＜0.05）。增强CT诊断准确性为91.9%，与B超CDFI比较，差异具有统计学意义（x2=5.716，P＜0.05）；与肝脏CEUS比较，差异无统计学意义（x2=7.672，P＜0.05)。结论 肝脏超声造影能够精准指导肝脏肿瘤微波消融治疗，精确地用于消融术后疗效评价和随访。

Application of contrast enhanced ultrasonography in microwave ablation for liver cancer

Objective To explore the applied value of contrast enhanced ultrasonography (CEUS) in microwave ablation for liver cancer. Methods Twenty-six patients with liver cancer treated with microwave ablation were summarized from Jan. 2008 to June 2012. Microwave ablation therapy was conducted in 62 lesions. Hepatic CEUS was conducted at pre-therapy, treatment period and post treatment. Twenty-two cases were treated with percutaneous microwave ablation technique, 4 cases were treated with intraoperative microwave ablation technique. Results The complication of bleeding, biliary leakage and infection, etc, didn't occurred in these patients. The accuracy of evaluating the therapeutic effect of microwave ablation with B type ultrasonic CDFI detection was 64.5%, hepatic CEUS was 95.2%, there was significant difference between CDFI detection and CEUS detection (x2=5.241, P<0.05). The accuracy of evaluating the therapeutic effect of microwave ablation with enhancement CT scanning was 91.9%, there was significant difference between CDFI detection and enhancement CT scanning (x2=5.716, P<0.05), but there was no significant difference between CEUS detection and enhancement CT scanning (x2=7.672, P>0.05). Conclusion Hepatic CEUS technique can be used to precisely guide microwave ablation therapy for liver cancer, exactly to evaluate the therapeutic effect and follow-up after microwave ablation.