摘要
目的探讨超声造影在肝癌射频消融前后的临床应用价值。方法选取2010年1月—2013年6月广西医科大学第一附属医院行射频消融治疗的肝癌(均经病理证实)患者65例,比较术前常规彩超、增强CT扫描和超声造影对肝癌病灶的检出率,对比常规彩超引导的60个病灶和超声造影引导的75个病灶射频消融后的疗效。结果65例肝癌患者中发现135个病灶,其中转移灶92个,原发灶43个。常规彩超检出病灶100个,检出率为74.1%;增强CT扫描检出病灶130个,检出率为96.3%;超声造影检出病灶128个,检出率为94.8%;3种影像学检查方法肝癌病灶检出率比较,差异有统计学意义(χ2=24.214,P=0.007);其中增强CT扫描和超声造影肝癌病灶检出率高于常规彩超(χ2=26.413和22.105,P=0.007和0.008);增强CT扫描与超声造影肝癌病灶检出率比较,差异无统计学意义(χ2=0.349,P=0.824)。常规彩超引导下60个肝癌病灶完全消融42个,完全消融率为70.0%;超声造影引导下75个肝癌病灶完全消融63个,完全消融率为84.0%,2种影像学检查方法下完全消融率比较,差异有统计学意义(χ2=5.538,P=0.041)。以术后1个月增强CT扫描检查作为标准,112个病灶完全消融,术后超声造影显示完全消融84个,正确率为75.0%。结论超声造影在肝癌射频消融前可以明显提高病灶的检出率,射频消融后可以提高对疗效的判定率,在肝癌射频消融前后均有较高的临床应用价值。
Objective To evaluate the application value of contrast- enhanced ultrasound before and after radiofrequency ablation of hepatic carcinoma. Methods From January 2010 to June 2013 in the First Affiliated Hospital of Guangxi Medical University,65 eligible patients with hepatic carcinoma（ confirmed by histopathology） recieved radiofrequency ablation. The preoperative detection rates of hepatic carcinoma lesion by conventional color ultrasound,enhanced CT and contrast- enhanced ultrasound were compared. The postoperative therapeutic effects of radiofrequency ablation between the 60 lesions guided by conventional color ultrasound and the 75 lesions guided by contrast- enhanced ultrasound were compared. Results A total of 135 lesions were found in 65 patients with hepatic carcinoma, including 92 metastatic lesions and 43 primary lesions. Conventional color ultrasound detected 100 lesions, the detection rate was 74. 1%; the enhanced CT detected 130 lesions,the detection rate was 96. 3%; the contrast- enhanced ultrasound detected 128 lesions,the detection rate was 94. 8%.The comparison of detection rates of lesions among 3 methods of imaging examination showed that the difference was statistically significant（ χ2= 24. 214,P = 0. 007）. The lesion detection rates by enhanced CT and contrast- enhanced ultrasound were higher than that by conventional color ultrasound, the difference was statistically significant（ χ2= 26. 413 and 22. 105, P= 0. 007 and 0. 008）. The lesion detection rates comparison between enhanced CT and contrast- enhanced ultrasound demonstrated that there was no significant difference（ χ2= 0. 349,P = 0. 824）. 42 of 60 lesions guided by conventional color ultrasound were completely ablated, the corresponding complete ablation rate was 70. 0%. Under the guidance of contrast-enhanced ultrasonography,63 of 75 lesions were completely ablated,the complete ablation rate was 84. 0%. The difference of complete ablation rates between these two imaging methods was statistically significant（ χ2= 5. 538,P = 0. 041）. One month after operations, taken enhanced CT examination as standard,112 lesions ablated completely, while contrast- enhanced ultrasonic angiography showed that 84 lesions were completely ablated,thus,the correct rate was 75. 0%. Conclusion Contrast- enhanced ultrasound can significantly improve the detection rate of lesions before radiofrequency ablation and improve the identification rate of curative effect after operation,consequently,possesses a higher clinical application value in radiofrequency ablation for hepatic carcinoma.
出处
《中国全科医学》
CAS
CSCD
北大核心
2015年第9期1090-1093,共4页
Chinese General Practice
基金
广西壮族自治区卫生厅科研课题(2011361)
关键词
超声检查
肝肿瘤
消融技术
Ultrasonography
Liver neoplasms
Ablation techniques
作者简介
通信作者：杨红，530021广西南宁市，广西医科大学第一附属医院超声诊断科；E-mail：2315396284@qq．com
