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目的研究肝恶性肿瘤微创治疗后实时超声造影表现,并与其他影像学对比,评价实时超声造影对微创治疗疗效判断的临床价值。方法评价肝恶性肿瘤微创治疗(TACE、RF)疗效33例次,病灶39个,治疗后进行实时超声造影检查,同期进行CT/MRI/DSA检查(造影前后2周内)。实时超声造影将病灶分为有增强和无增强。结果微创治疗后,实时超声造影显示动脉期局部增强区22个病灶(56.4%);17个病灶无增强。同期CT/MRI/DSA显示20个病灶(52.6%)有肿瘤复发或残存,以后者为对照,超声造影评价肝恶性肿瘤微创治疗疗效的敏感性为86.8%,特异性为78.6%,符合率为83.6%。TACE、RF两种肝脏恶性肿瘤治疗后比较,TACE治疗后,实时超声造影对疗效评估的敏感性、特异性及符合率分别为91.7%,84.6%,83.3%,是几种评价方法中最高的。结论实时超声造影用来评价肝脏恶性肿瘤微创治疗疗效,比较可靠,并且更适于TACE治疗后的疗效评价。
Objective To study the real-time contrast-enhanced ultrasonography after minimally invasive treatment of hepatic malignancies and to evaluate the clinical value of real-time contrast echocardiography in judging the curative effect of minimally invasive treatment compared with other imaging studies. Methods Thirty-three cases of minimally invasive treatment of malignant tumor of liver (TACE, RF) and 39 lesions were retrospectively studied. Real-time contrast-enhanced ultrasound and CT / MRI / DSA were performed before and after treatment. Real-time CEUS divided the lesions into enhanced and non-enhanced. Results After minimally invasive treatment, real-time contrast-enhanced ultrasound showed 22 lesions (56.4%) in the arterial phase of local enhancement; 17 lesions were not enhanced. CT / MRI / DSA showed that 20 lesions (52.6%) had tumor recurrence or remnant in the same period. The latter was control. The sensitivity and specificity of CEUS in minimally invasive treatment of hepatic malignancies were 86.8% and 78.6% 83.6%. After TACE and RF treatment, the sensitivity, specificity and coincidence rate of real-time contrast-enhanced ultrasonography after TACE treatment were 91.7%, 84.6% and 83.3%, respectively, which were the highest among several evaluation methods . Conclusions Real-time contrast-enhanced ultrasound is a reliable and reliable method for evaluating the efficacy of minimally invasive treatment of malignant liver tumors, and is more suitable for the evaluation of the curative effect after TACE treatment.