超声造影评价肝癌微波治疗疗效的初步应用

目的　探索超声造影能量多普勒血流检查评价微波治疗疗效的价值。方法　超声造影剂Levovist检查17例肝癌经皮微波凝固治疗病人。治疗前1d内及治疗后3d、7d对比检查能量多普勒血流图(PDI)、超声造影能量多普勒血流图(CEPDI)及瘤区再活检，并于治疗后1个月、3个月及6个月超声及增强CT随访。结果　(1)造影后CEPDI肿瘤区血流信号显示率明显增加(P＜0.05)，并能显示瘤内细小血管的分布状况及其与周边血管尤其是肿瘤滋养血管及其分支进入肿瘤的详细部位；治疗后CEPDI瘤内及周边肿瘤滋养血管消失；(2)肝癌造影瘤内能量多普勒血流信号增强峰值时间平均43.3s，持续时间179.9s；(3)治疗后CEPDI瘤内血流阴性者再活检肿瘤坏死完全。结论　超声造影能量多普勒血流成像能清楚显示肝肿瘤滋养血管及其分支以及肿瘤内的分布状况，并能于治疗后短期内及时判断肿瘤坏死情况，可望成为临床超声检查观测肝癌局部治疗疗效并指导治疗的有效可靠方法。

An initial application in assessment of efficacy for liver cancer percutaneous microwave therapy using contrast-enhanced ultrasound

Objective To evaluate the role of Contrast Enhanced Power Doppler Imaging in liver cancer percutaneous microwave therapy. Methods We performed Power Doppler Imaging(PDI), Contrast Enhanced Power Doppler Imaging(CEPDI), re biopsy before and the 3rd, 7 th day after liver cancer percutaneous microwave therapy with contrast agent, Levovist, on 17 cases. Results 1) The Doppler flow signals increased remarkably (P<0 05) on CEPDI as comparing with conventional PDI. Meanwhile, it could visualize the construction of the vessels in tumor. 2) The mean max enhanced PDI occurred at 43.3 s and signals continued for 179.9 s. 3) The cases with CEPDI negated within the tumor were negative on re biopsy result. Conclusion The method of CEPDI can be an effective method for percutaneous microwave therapy postprocedural assessment and guidance of therapy.