论文部分内容阅读
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。
Objective To investigate the role of contrast-enhanced ultrasound (CEUS) time-curve in evaluating the efficacy of microwave ablation in primary liver cancer. Methods A total of 103 lesions of 65 cases of primary liver cancer were treated by microwave ablation. The results of contrast-enhanced ultrasound and contrast-enhanced MRI were compared. Results Before treatment, there were 103 malignant tumor nodules and 101 enhanced MRI findings on the time-intensity curve of CEUS. There was no significant difference between them (P> 0.05). After treatment, contrast-enhanced ultrasound (CEUS) showed no evidence of contrast-agent filling, disappearance of contrast agent, disappearance of contrast-enhanced ultrasound, enhancement of IMAX, rise time (RT), peak time (TTP) ≈0, consistent with enhanced MRI, reflecting the size of the lesion better; while incomplete ablation, the time of contrast enhancement and the time-intensity curve were significantly enhanced. Compared with normal tissue, The difference was statistically significant (P <0.05), consistent with enhanced MRI, visible focal area “fast forward fast ” blood perfusion, but enhanced MRI no abnormalities. The sensitivity and accuracy of contrast-enhanced ultrasound in evaluating the efficacy of microwave ablation were 97.8% and 94.2%, respectively. Conclusion Time-intensity curve of ultrasound contrast can intuitively and dynamically reflect the blood perfusion before and after microwave ablation of primary liver cancer. It has great clinical value in evaluating the therapeutic effect.