目的　探讨三维超声导向射频治疗肝癌的临床价值。方法　应用三维超声导向对 3 0例肝癌患者的 42个肿瘤结节进行射频治疗。在三维声像图下 ,可见穿刺针尖在肿瘤内呈“伞形”散开 ,用 80 10 0W的功率烧灼 10 3 0min ,由深至浅多点多次 ,覆盖整个病灶及周围 6 10mm的正常组织 ,对 <5cm的肿瘤 ,一般 1 3次重叠烧灼 ,>5cm的肿瘤根据病人身体状况 ,至少 4 8次以上重叠烧灼。结果　三维超声导向穿刺成功 2 8例 ( 78% 99% ) ;射频治疗后有 2 5例( 65 % 94% )的肿瘤血供减少 ,随着肿瘤血流减少肿块大小也有不同程度缩小 ,而血供减少不明显者肿瘤缩小也不明显。结论　三维超声导向射频治疗肝癌成功率高 ,能较好地判断穿刺针与肿瘤的位置和布针情况 ,是一种有效的微创治疗方法 ;彩色多普勒可即时检测肿瘤治疗中血供的变化 ,对评价射频治疗肝癌的疗效具有临床价值。 Objective To investigate the clinical value of three-dimensional guided radiofrequency ablation in the treatment of liver cancer. Methods Three-dimensional ultrasound guided radiofrequency treatment of 42 tumor nodules in 30 patients with liver cancer. In the three-dimensional sonography, visible puncture tip in the tumor was “umbrella” scattered, with 8010W power burning 1030min, from deep to shallow multi-point many times, covering the entire lesion and the surrounding 6 10mm normal Tissue, <5cm of the tumor, the general 13 times overlapping cautery,> 5cm tumor according to the patient’s physical condition, at least 48 times more overlapping cautery. Results Twenty-eight cases (78%, 99%) were successfully treated with three-dimensional guided ultrasound. Twenty-five (65% 94%) of the tumor blood decreased after radiofrequency ablation. As the tumor blood flow reduced, the size of the tumor decreased to some extent. Not reduce the obvious for those who reduce the tumor is not obvious. Conclusion Three-dimensional ultrasound-guided radiofrequency treatment of high success rate of liver cancer, can better determine the location of the needle and the tumor and cloth needle situation, is an effective minimally invasive treatment; color Doppler real-time detection of cancer treatment of blood supply changes , The evaluation of the efficacy of radiofrequency treatment of liver cancer has clinical value.