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目的观察肝细胞性肝癌(hepatocellular carcinoma,HCC)施行经皮肝动脉栓塞化疗(transcatheter arterial chemoembolization,TACE)治疗后的超声造影(contrast-enhanced ultrasound,CEUS)表现,并探讨超声造影定量分析评价肝细胞性肝癌施行治疗后残留/复发灶的临床应用价值。方法对42例HCC患者共47个病灶行TACE治疗,在低机械指数状态下进行实时CEUS,并进行评价疗效;采用时间-强度量化分析软件检测治疗后残留病灶内血流灌注的信息。结果 HCC病人施行TACE治疗后,超声造影显示,8个病灶三期无增强,39个病灶局部有增强。以同期DSA结果为对照标准,超声造影诊断TACE治疗后残留/复发的灵敏度为97.4%,特异度为87.5%,准确度为95.7%。CEUS时间-强度量化分析表明,38个残留、复发灶治疗前后,增强强度与达峰时间差异有统计学意义(P<0.05)。结论 CEUS可以作为HCC病人TACE治疗的疗效评估的可靠方法,时间-强度量化分析有助于客观评价残留/复发灶的血供。
Objective To observe the contrast-enhanced ultrasound (CEUS) performance of hepatocellular carcinoma (HCC) treated with transcatheter arterial chemoembolization (TACE) and to evaluate the value of quantitative contrast echocardiography Clinical value of residual / recurrent foci after treatment of patients with. Methods A total of 47 lesions of 42 patients with HCC underwent TACE. Real-time CEUS was performed under the condition of low mechanical index, and the effect was evaluated. Time-intensity quantitative analysis software was used to detect the information of blood perfusion in the residual lesion after treatment. Results After HCC patients underwent TACE, CEUS showed no enhancement in the third stage of eight lesions and local enhancement in 39 lesions. According to the DSA results of the same period, the sensitivity and specificity of contrast-enhanced ultrasound in the diagnosis of residual / recurrence after TACE were 97.4%, 87.5% and 95.7% respectively. CEUS time-intensity quantitative analysis showed that there was a significant difference between the enhancement intensity and the peak time before and after the treatment of 38 residual and recurrence lesions (P <0.05). Conclusion CEUS can be used as a reliable method to evaluate the curative effect of TACE in patients with HCC. Time-intensity quantitative analysis can help to objectively evaluate the blood supply of residual / recurrent foci.