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目的:评估SonoVue谐波超声造影即刻判定经皮微波凝固治疗(PMCT)肝细胞癌残余瘤的疗效和用途。材料和方法:53例肝细胞癌患者的55个癌灶(1.3～6.0cm)经皮微波凝固治疗后,经肘部静脉团注射SonoVue,观察癌灶凝固治疗区造影的增强情况。引导临床实施肝细胞癌治疗区穿刺活检,对治疗区局部动态超声增强部位,追加二次PMCT。治疗1周内,全部患者进行增强CT随访,之后,每月随访一次,随访6月。结果:46个无超声动态增强治疗区,其中1个组织病理证实为残余瘤存在。9个治疗区局部呈结节形或新月形动态增强,组织病理学检查证实为残余瘤存在。以病理组织学所见结果为诊断标准,谐波超声造影结果与之比较,其检测肝细胞癌凝固区残余瘤的敏感性、特异性和准确性分别为90%、100%和98.2%。随访增强CT检查,9个补加PMCT肝细胞癌治疗区中,1个显示CT强化。结论:谐波超声造影是一种PMCT肝细胞癌后及时判断治疗效果,并指导临床治疗残余瘤的有效方法。
OBJECTIVE: To evaluate the efficacy and purpose of SonoVue Harmonic contrast echocardiography in determining the residual tumor of hepatocellular carcinoma after percutaneous microwave coagulation therapy (PMCT). Materials and Methods: Percutaneous microwave coagulation therapy was performed on 55 cancerous lesions (1.3 ~ 6.0cm) in 53 patients with hepatocellular carcinoma. SonoVue was injected through the elbow vein to observe the contrast enhancement in the coagulation area. Guide the clinical implementation of hepatocellular carcinoma in the treatment area biopsy, the treatment area of local dynamic ultrasound enhanced site, additional secondary PMCT. All patients underwent enhanced CT follow-up within 1 week of treatment, followed by monthly follow-up of 6 months. Results: There were 46 non-ultrasonic dynamic enhanced treatment areas, of which 1 histological confirmed the presence of residual tumor. Nine treatment areas were nodular or crescent-shaped dynamic enhancement, histopathological examination confirmed the presence of residual tumor. Histopathological findings as diagnostic criteria, harmonic contrast echocardiography compared with the detection of residual tumor in the area of hepatocellular carcinoma sensitivity, specificity and accuracy were 90%, 100% and 98.2%. Follow-up enhanced CT examination, 9 additional PMCT hepatocellular carcinoma treatment area, 1 showed CT enhancement. Conclusions: Harmonic contrast echocardiography is an effective method for judging the curative effect of PMCT hepatocellular carcinoma in time and guiding the clinical treatment of residual tumor.