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目的 探讨肝癌肝动脉栓塞(TAE)治疗疗效即时评估的新方法。方法 对肝癌行TAE患者,即时观察碘油栓塞后肿瘤声像图变化,然后经介入导管注射超声造影剂,动态观察造影剂在瘤内分布以评估肿瘤血管的栓塞程度,并和介入当时X线显示的碘油沉积和彩色多普勒显示的肿瘤血流信号作对照。结果 肝超声造影,5个病灶显示瘤内无造影剂进入,3个病灶显示肿瘤周边局部有少量造影剂进入,1个病灶清晰显示造影剂沿肿瘤血管蜿蜒迂曲进入肿瘤内部,并使瘤内较大范围回声增强。而栓塞治疗当时8例9个病灶在X线下均显示肿瘤内碘油充盈良好;彩色多普勒仅1个病灶内检测到搏动性彩点。应用超声造影评估的TAE栓塞效果和TAE治疗后随访的实际疗效相符合。结论 肝动脉超声造影能在TAE当时评估TAE的远期疗效,且优于X线及彩色多普勒检测
Objective To explore a new method for the immediate evaluation of therapeutic efficacy of hepatic artery embolization (TAE). Methods The TAE patients with hepatocellular carcinoma were immediately observed for changes in the acoustic image of the tumor after lipiodol embolization. Then the ultrasound contrast agent was injected through the interventional catheter to dynamically observe the distribution of the contrast agent in the tumor to evaluate the degree of embolization of the tumor vessels. The iodide deposition shown is contrasted with the color Doppler displayed tumor blood flow signal. RESULTS: During contrast-enhanced ultrasound, 5 lesions showed no entry of contrast agent into the tumor, 3 lesions showed a small amount of contrast agent entering the periphery of the tumor, and 1 lesion showed clearly that the contrast agent was oscillated along the tumor vessel and entered the tumor and caused intratumoral invasion. A larger range of echo enhancements. At the time of embolization treatment, 8 lesions in 8 cases showed good iodized oil filling in the tumor under X-rays, and pulsatile color dots were detected in only one color Doppler lesion. The effect of TAE embolization assessed by contrast-enhanced ultrasound was consistent with the actual follow-up after TAE treatment. Conclusions Contrast-enhanced hepatic arterial angiography can evaluate the long-term efficacy of TAE at the time of TAE, and is superior to X-ray and color Doppler detection.