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目的探讨超声图像监控在高强度聚焦超声(HIFU)联合射频(RFA)治疗大肝癌(直径>5cm)肿瘤时的作用。方法利用HIFU联合RFA治疗大肝癌患者76例,观察肝癌组织术中、术后超声图像的变化,并对照手术前后腹部MRI结果进行对比分析。结果HIFU及RFA治疗时,可见超声灰阶增强,术后随访癌灶血流减少或消失,术后MRI显示治疗靶区坏死明显,坏死区与超声定位治疗靶区相一致,提示超声定位及监控准确,周围邻近脏器未见损伤。结论超声是目前HIFU及RFA治疗大肝癌时较好的定位及治疗监控手段。
Objective To investigate the role of ultrasound image monitoring in the treatment of large hepatocellular carcinoma (diameter> 5cm) tumors with high intensity focused ultrasound (HIFU) and radio frequency (RFA). Methods HIFU and RFA were used to treat 76 patients with large hepatocellular carcinoma. The changes of intraoperative and postoperative ultrasound images of hepatocellular carcinoma were observed. The MRI findings of abdominal muscles before and after surgery were compared and analyzed. Results When HIFU and RFA were treated, the gray scale of the ultrasound was enhanced. The blood flow of the foci decreased or disappeared after the operation. The postoperative MRI showed that the necrosis of the target area was obvious. The necrotic area was consistent with the target of ultrasound localization treatment. Accurate, no damage around the adjacent organs. Conclusion Ultrasound is the better positioning and treatment monitoring method for HIFU and RFA in the treatment of large liver cancer.