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目的探讨虚拟导航超声造影在常规超声不能检出的肝脏小占位病灶中进行微波消融治疗的精准定位中的应用价值。方法选取南方医院2015年1月至2017年3月期间的23例患者共28个常规超声不能检出而由CT/MRI提示的肝脏小占位,借助实时虚拟导航超声造影系统对其进行微波消融治疗。融合了超声和CT/MRI图像后,在实时超声监控下对病灶进行微波消融治疗,并于术后使用虚拟导航超声造影评价消融效果。术后1个月对所有患者进行CT/MRI检查评价微波消融的疗效。结果所有病灶经过虚拟导航系统均可达到超声与CT/MRI图像融合。所有病例在虚拟导航超声造影系统的监测下进行了微波消融治疗,只有1例患者消融后发现少许残留,需即时再次行消融治疗。本组患者均无发生严重并发症。术后1个月的CT/MRI检查显示所有患者均达到完全消融。结论虚拟导航超声系统可以精准定位常规超声不能检出的肝脏小占位,并利用虚拟导航超声造影在围手术期评估病灶性质和消融疗效,具有良好的临床应用价值。
Objective To investigate the value of virtual navigation contrast-enhanced ultrasound (CEUS) in the precise localization of microwave ablation in small hepatic lesions that conventional ultrasound can not detect. Methods Twenty-eight patients in Nanfang Hospital from January 2015 to March 2017 were selected for microwave ablation by real-time virtual navigation contrast-enhanced ultrasound system. Totally 28 hepatic tumors were detected by CT / MRI. treatment. After fusion of ultrasound and CT / MRI images, the lesions were treated with microwave ablation under the real-time ultrasound monitoring. Virtual ablation contrast-enhanced ultrasound was used to evaluate the ablation effect. All patients underwent CT / MRI 1 month after surgery to evaluate the efficacy of microwave ablation. Results All lesions could be fused with CT / MRI images through virtual navigation system. All patients underwent microwave ablation under the guidance of virtual navigation ultrasound contrast system. Only one patient found a little residual after ablation, and the ablation was needed again. No serious complications occurred in this group of patients. One month after the CT / MRI examination showed complete ablation in all patients. Conclusion The virtual navigation ultrasound system can accurately locate small hepatic liver tumors that can not be detected by conventional ultrasound. It is of great value in clinical application to evaluate the characteristics of lesions and ablation by virtual navigation contrast echocardiography during perioperative period.