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目的探讨立体定向伽马射线全身治疗系统(以下简称SGS-I)治疗原发性肝癌的超声表现及价值。方法32例原发性肝癌患者接受SGS-I治疗前后行超声检查,对比治疗前后超声改变。对3例治疗效果欠佳的病灶术后行病灶切除,观察其病理组织学改变,并与超声表现对照。结果治疗后5例(5/32,15.6%)肿块基本消失;21例(21/32,65.6%)病灶体积缩小,血流消失;27例(27/32,84.4%)病灶体积未见明显改变,但病灶回声见不同程度减低,肿块内部分出现暗区,声晕不明显,血流减少或消失,未见动脉型血流频谱。2例(2/3,66.7%)门静脉癌栓消散,9例(9/11,81.8%)少量腹水吸收。术后体积未见明显改变的27例病灶中有3例行组织病理学检查,发现SGS-I治疗区内肿瘤组织出现凝固性坏死。结论超声可以反映SGS-I治疗原发性肝癌后瘤体组织学与血供变化,对评价SGS-I治疗原发性肝癌的效果及预后具有重要价值。
Objective To investigate the ultrasound performance and value of stereotactic gamma ray system therapy (hereinafter referred to as SGS-I) in the treatment of primary liver cancer. Methods Thirty-two patients with primary liver cancer underwent ultrasound examination before and after treatment with SGS-I, and the changes of ultrasound before and after treatment were compared. Three cases of poorly treated lesions were resected and the histopathological changes were observed and compared with the ultrasound findings. Results After treatment, 5 cases (5/32, 15.6%) had almost disappeared. The lesions of 21 cases (21/32, 65.6%) were reduced in size and the blood flow disappeared. There was no significant difference in 27 cases (27/32, 84.4% Change, but lesion echo reduced to varying degrees, dark mass within the area, no obvious sound halo, blood flow decreased or disappeared, no arterial blood flow spectrum. Two cases (2/3, 66.7%) of portal vein tumor thrombus dissipated, and 9 cases (9 / 11,81.8%) of ascites were absorbed. Three of the 27 lesions with no significant change in postoperative volume were histopathologically examined and found to have coagulation necrosis in the tumor tissue in the SGS-I treated area. Conclusion Ultrasound can reflect the changes of histology and blood supply after treatment of primary liver cancer with SGS-I, which is of great value in evaluating the effect and prognosis of SGC-I in treating primary liver cancer.