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目的探讨超声造影(CEUS)评估原发性肝癌(HCC)经导管肝动脉灌注化疗栓塞术(TACE)治疗的近期疗效。方法对58例HCC患者在TACE术前和术后当天、第5天和第30天采用CEUS检查,重点分析肿瘤滋养动脉供血情况变化,同时观察肿瘤供血方式,根据CEUS结果对滋养动脉进行分型和血流分级,并与术中数字减影血管造影(DSA)图像进行比较。所有病例治疗前后均有完整的常规彩超,CEUS,增强CT(或增强MRI)及DSA造影各期影像资料。结果 58例HCC介入治疗前后CEUS检出肿瘤滋养动脉者分别为39例(67.24%)和19例(32.76%),术前CEUS声像图动脉相为多条连续性强回声带延伸至肿块内(或包绕肿瘤);CEUS显示滋养动脉抱球型、延续型和浓密型分别为8例(13.79%)、35例(60.35%)和15例(25.86%),术后显示为非连续性彩带进人肿块内或终止于肿瘤边缘或无血管像。结论超声造影能清晰显示肿瘤滋养动脉,其检查结果与DSA表现基本接近,可作为肝癌TACE术后疗效评估手段。
Objective To evaluate the short-term efficacy of contrast-enhanced ultrasound (CEUS) in the evaluation of transcatheter arterial chemoembolization (TACE) of primary hepatocellular carcinoma (HCC). Methods 58 patients with HCC underwent TACE before CEA and CEA on day 5, day 30, and day 30. The focus was on analyzing the changes of tumor nourishing artery blood supply, and observing the way of tumor blood supply. According to CEUS results, And blood flow were compared with intraoperative digital subtraction angiography (DSA) images. All cases before and after treatment have a complete routine ultrasound, CEUS, enhanced CT (or enhanced MRI) and DSA imaging stages of imaging data. Results There were 39 cases (67.24%) and 19 cases (32.76%) with CEUS detected by CEUS before and after interventional therapy in 58 cases. The preoperative CEUS sonography showed multiple continuous echogenic bands extending into the tumor (Or enveloping tumor). CEUS showed that there were 8 cases (13.79%), 35 cases (60.35%) and 15 cases (25.86% Ribbon into the tumor or at the end of the tumor edge or avascular image. Conclusion Contrast-enhanced ultrasound can clearly show the tumor nourish artery. The examination results are close to those of DSA. It can be used as a curative measure of TACE of liver cancer.