超声造影时间-强度曲线在评价原发性肝癌微波消融术疗效中的作用

目的探讨超声造影时间-强度曲线在评价原发性肝癌微波消融术疗效中的作用。方法65例原发性肝癌共103个病灶采用微波消融治疗,对消融灶超声造影与增强MRI检查结果进行比较。结果治疗前,超声造影时间-强度曲线发现恶性肿瘤结节103个,增强MRI发现101个,两者差异无统计学意义(P>0.05)。治疗后,超声造影对完全消融病灶表现为肿瘤血流灌注消失,未见造影剂填充,超声造影时间-强度曲线表现为无增强,参数峰值强度(IMAX)、上升时间(RT)、达峰时间(TTP)≈0,与增强MRI相符,较好地反映了消融灶大小;而对不完全消融,其造影时相增强,时间-强度曲线明显强化,其IMAX、RT、TTP与正常组织比较,差异有统计学意义(P<0.05),与增强MRI相符,可见病灶区"快进快出"血流灌注,但增强MRI未见异常。超声造影判定微波消融术疗效的灵敏度和准确率分别为97.8%和94.2%。结论超声造影时间-强度曲线可直观、动态反映原发性肝癌微波消融术治疗前后血流灌注,在评价治疗效果中有较大的临床应用价值。

The evaluation effect of ultrasound contrast time intensity curve in hepatocellular carcinoma treated by microwave ablation

Objective To investigate the evaluation effect of ultrasound contrast time intensity curve in hepatocellular carcinoma treated by microwave ablation. Methods 65 cases （ 103 lesions） with hepatocellular carcinoma microwave ablation were selected, CEUS and contrast-enhanced MRI examination were compared. Results Before treatment, 103 lesions are found in CEUS, while MRI 101 （P 〉 0. 05）, after treatment, CEUS of complete ablation show disappearance of tumor perfusion, no contrast agent filled without enhancement, IMAX, RT, TTP ≈ 0, enhanced MRI agree, can better reflect ablation lesions size, but incomplete ablation is enhanced obviously, IMAX, RT, TIP compared with normal tissues have significant difference （ P 〈 0.05 ） enhanced MRI agree, ＂first in, first out＂ blood perfusion while enhanced MRI showed no abnormalities, follow-up results evaluation standard, CEUS sensitivity and accuracy are as high as 97.8% , 94. 2%. Conclusion Ultrasound contrast time intensity curve can directly, dynamic reflect perfusion of microwave ablation, it has great clinical application value in evaluation efficiency.