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目的:探讨肝癌射频消融(radiofrequency ablation,RFA)后实时超声造影(contrast-enhanced ultrasound,CEUS)对判断治疗效果的临床应用价值。方法:对经RFA治疗的205例肝癌患者205个病灶术后1个月分别进行常规超声和低机械指数(MI<1.0)CEUS检查(造影剂为SonoVue),比较分析常规超声与CEUS在评价肝癌射频消融效果及局部复发中的应用价值。所有患者均同期行增强CT或增强MRI检查。结果:常规超声检查提示92个病灶(44.9%)周边出现低回声区,或于病灶局部检及血流信号,常规超声判断消融不全或局部复发的敏感性为77.5%,特异性为76%;CEUS检查提示80个病灶(39.0%)于动脉期可见造影剂局部充填,CEUS判断消融不全或局部复发的敏感性为97.5%,特异性为98.4%。结论:与常规超声比较,CEUS可以更准确判断RFA术后消融程度及局部复发情况,与增强CT/MRI相当,可为射频治疗术后疗效的判断提供可靠的影像学依据。
Objective: To investigate the clinical value of contrast-enhanced ultrasound (CEUS) after radiofrequency ablation (RFA) for evaluating the therapeutic effect of hepatocellular carcinoma. Methods: The routine ultrasound and low mechanical index (MI <1.0) CEUS examination (contrast agent SonoVue) were performed on 205 lesions of 205 patients with liver cancer treated by RFA. The correlation between routine ultrasound and CEUS in the evaluation of liver cancer Radiofrequency ablation and its application in local recurrence. All patients underwent concurrent enhanced CT or enhanced MRI examination. Results: Conventional ultrasonography showed hypoechoic areas in 92 lesions (44.9%), local seizures and blood flow signals in lesions. The sensitivity and specificity of conventional ultrasound were 77.5% and 76%, respectively. The CEUS examination showed that 80 lesions (39.0%) showed local filling of contrast agent during arterial phase. The sensitivity and specificity of CEUS in diagnosing ablation or local recurrence were 97.5% and 98.4% respectively. CONCLUSIONS: Compared with conventional ultrasound, CEUS can determine more accurately the degree of ablation and local recurrence after RFA, which is comparable with enhanced CT / MRI. It can provide a reliable imaging basis for judging the curative effect after radiofrequency ablation.