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目的 探讨能量多普勒声学造影对兔VX2 肝癌微波凝固治疗的疗效评价 ,及其对残存瘤组织检查的敏感性与特异性。方法 应用UMC 1型微波治疗仪 ,频率 2 45 0MHz ,16G防粘植入性天线 ,芯线裸露长度为 9mm ,对 10只兔VX2 肿瘤行开腹微波辐射治疗 ,60W× 12 0s。治疗前后均行能量多普勒声学造影 ,灌注 延迟法观察肿瘤结节内血流变化。结果 微波治疗后造影检查 ,6例VX2 肿瘤仅于静脉相观察到稀疏的点状血流 ,2周后病理证实为完全坏死。 4例首次治疗后肿瘤内可见持续血流增强 ,对该区二次微波治疗后 ,3例结节内未见血流 ,1例静脉相边缘有持续血流显示 ,2周后再次行造影检查 ,可见中心及周边血流明显增多 ,病理证实为不完全坏死。结论 能量多普勒声学造影能早期评估微波凝固治疗VX2 肿瘤的疗效 ,并能指导再次治疗的目标区域 ,残存瘤组织表现为肿瘤内持续造影增强
Objective To investigate the efficacy of power-Doppler contrast echocardiography in the microwave coagulation therapy of rabbit VX2 hepatocellular carcinoma and its sensitivity and specificity for the examination of residual tumor tissue. METHODS UMC 1 type microwave therapeutic apparatus, frequency 2 45 0MHz, 16G anti-sticking implanted antenna, exposed length of core wire was 9mm, and 10 rabbit VX2 tumors were treated with open microwave irradiation, 60W×12 0s. Power Doppler echocardiography was performed before and after treatment, and perfusion delay was used to observe changes in blood flow within tumor nodules. RESULTS: After microwave therapy, 6 VX2 tumors showed sparse punctate blood flow only at the venous phase. After 2 weeks, pathological examination confirmed complete necrosis. Continuous blood flow was observed in the tumors of the 4 patients after the first treatment. No blood flow was found in 3 nodules after the 2nd microwave treatment in the zone, and 1 case showed continuous blood flow at the edge of the venous phase. 2 weeks later, angiography was performed again. The blood flow at the center and peripheral areas was significantly increased, and pathology proved to be incomplete necrosis. Conclusion Power Doppler echocardiography can early evaluate the efficacy of microwave coagulation in the treatment of VX2 tumors, and can guide the target area for retreatment. The residual tumor tissue manifests as continuous intracranial contrast enhancement.