摘要
目的探讨超声造影在肝脏残留复发性恶性肿瘤射频消融中的应用。方法选取2014年6月至2016年6月间山东省临沂市肿瘤医院收治的78例肝脏残留复发性恶性肿瘤患者(113个病灶)为超声造影引导组,另选取同期接受常规超声检查的80例患者(118个病灶)为常规超声引导组。记录超声造影引导组患者治疗前后病灶数量、大小、边界及内部回声情况,将其术前肿瘤检出率、术中穿刺成功率及术后射频消融准确率,与常规超声引导组进行比较。结果超声造影引导组射频消融术后,实时谐波超声造影诊断,113个病灶中有6个(5.3%)可见动脉相内有局部增强区,门脉及延迟相增强区快速消退呈现低增强,判断仍存在残留。余107个(94.7%)病灶行超声造影始终未见增强,边界清晰,判断肿瘤已经完全灭活。超声造影引导组术前肿瘤检出率、术中穿刺成功率和肿瘤完全消融率分别为92.0%、92.9%和94.7%,常规超声引导组分别为80.5%、76.3%和83.9%,两组比较,差异均有统计学意义(均P<0.05)。结论超声造影在判断肝脏残留复发性恶性肿瘤射频消融术效果方面,提高了肿瘤诊断的敏感性、穿刺成功率和射频治疗准确性。
Objective To probe into ultrasound contrast in radiofrequency ablation for residual or recurrent malignant liver tumors. Methods A total of 78 patients（ 113 lesions） with residual or recurrent liver cancer treated at Tumor Hospital of Linyi between June 2014 and June 2016 as the ultrasound contrastguided group and another 80 patients（ 118 lesions） undergoing conventional ultrasound examination were selected as the conventional ultrasound-guided group. The number of lesions,size,border and internal echo were recorded in ultrasound contrast-guided group before and after the treatment. Preoperative tumor detection rate,intraoperative puncture success rate and the accuracy of postoperative radiofrequency ablation were compared between the two groups. Results Before radiofrequency ablation,ultrasound contrast-guided group received ultrasound contrast examination and all the tumors partly or totally had rich blood supply. After the radiofrequency ablation,real-time harmonic contrast diagnosis was performed. Six（ 5. 3%） of 113 lesions was found to have visible local enhancement in arterial phase and portal and delayed phase enhanced area present a low increase of fast fading,according to which a conclusion can be reached than residual lesions may exist. The rest 107（ 94. 7%） lesions underwent ultrasonic imaging and enhancement was never found. Well-defined and anechoic performance revealed tumors were completely inactivated. Tumor detection rate,success rate of intra-operative puncture and complete ablation rate were 92. 0%,92. 9% and94. 7%,respectively for the ultrasound contrast-guided group and 80. 5%,76. 3% and 83. 9%,respectively for the conventional ultrasound group（ all P〈0. 05）. Conclusion Ultrasonic contrast has a certain guiding role in improving the sensitivity of the diagnosis of tumors,success rate of puncture and accuracy of radiofrequency ablation for residual or recurrent malignant liver tumors.
出处
《中国肿瘤临床与康复》
2017年第11期1313-1316,共4页
Chinese Journal of Clinical Oncology and Rehabilitation
关键词
超声造影
肝脏
复发性恶性肿瘤
射频消融
Ultrasound contrast
Liver
Recurrent malignant neoplasms
Radiofrequencyablation
