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目的探讨超声造影(CEUS)评估肝癌介入治疗近期疗效的价值。方法 55例肝癌患者62个癌灶接受介入治疗。其中,超声引导经皮穿刺无水酒精注射(PEI)13个,超声引导局部经皮微波热凝固治疗(PMCT)27个,肝动脉化疗栓塞(TACE)22个。所有病例治疗前后均行常规彩超和超声造影检查,观察病灶造影各时相表现,以增强CT、增强MRI及超声造影各期均无增强作为肿瘤完全灭活的指标,动脉期治疗区内和/或周边有不规则增强,提示肿瘤残存。结果 62个癌灶治疗后增强MRI显示肿瘤残存活性灶20个,超声造影显示19个,增强CT显示20个。增强MRI及超声造影同时显示复发病灶1个,增强CT未显示,常规彩超仅检出肿瘤残存活性灶8个。超声造影和增强CT对肝癌局部介入治疗后疗效判断的正确性、敏感性高于常规彩超(P<0.01)。结论 CEUS可以动态显示局部治疗区及残存病灶的形态及微循环特点,对肝癌介入治疗后疗效评价有应用价值。
Objective To investigate the value of contrast-enhanced ultrasound (CEUS) in evaluating the short-term curative effect of interventional treatment of liver cancer. Methods 55 cases of liver cancer in 62 patients received interventional treatment. Thirteen ultrasound-guided percutaneous ethanol perfusion (PEI) guided ultrasound guided 27 percutaneous microwave thermocoagulation (PMCT) and 22 transcatheter arterial chemoembolization (TACE). All cases before and after treatment were performed conventional ultrasound and contrast-enhanced ultrasound contrast-enhanced ultrasound were observed at various phases of the lesion to enhance CT, enhanced MRI and contrast enhanced ultrasound were not enhanced as a complete tumor inactivation index, arterial phase and / Or around the irregular increase, suggesting that the tumor remains. Results After the treatment of 62 lesions, MRI showed that there were 20 surviving lesions in the tumor, 19 with contrast-enhanced ultrasound and 20 with enhanced CT. Enhanced MRI and contrast-enhanced ultrasound showed one recurrent lesion at the same time, enhanced CT did not show, routine color Doppler ultrasound detected only 8 surviving tumor lesions. The correctness and sensitivity of contrast-enhanced ultrasound and enhanced CT in judging the curative effect of HCC after local intervention were higher than those of conventional ultrasound (P <0.01). Conclusions CEUS can dynamically display the morphological and microcirculation characteristics of the local and residual lesions and has value for the evaluation of curative effect after interventional treatment of liver cancer.