CAJ | 학술논문

目的:探讨应用超声造影技术评价高强度聚焦超声(HIFU)治疗原发性肝细胞癌(HCC)的有效性.方法:HIFU治疗HCC患者32例, 分别采取部分覆盖肿瘤治疗23例及完全覆盖肿瘤治疗9例,于治疗前和治疗后1-4 d行超声造影检查, 通过对比观察HIFU治疗前后肿瘤内血流灌注变化来判断肿瘤是否凝固性坏死.结果:HIFU治疗前超声造影显示肿瘤内血流灌注丰富; HIFU治疗后, 超声造影显示治疗区无血流灌注, 提示治疗区域发生凝固性坏死.以最终诊断为金标准, 超声造影对肿瘤灭活诊断的准确性高于常规彩超(90.6% vs 46.9%,P <0.05).结论:超声造影能准确判断HIFU对肿瘤消融范围及程度, 为HCC患者HIFU治疗后的早期疗效评价提供依据.
목적:탐토응용초성조영기술평개고강도취초초성(HIFU)치료원발성간세포암(HCC)적유효성.방법:HIFU치료HCC환자32례, 분별채취부분복개종류치료23례급완전복개종류치료9례,우치료전화치료후1-4 d행초성조영검사, 통과대비관찰HIFU치료전후종류내혈류관주변화래판단종류시부응고성배사.결과:HIFU치료전초성조영현시종류내혈류관주봉부; HIFU치료후, 초성조영현시치료구무혈류관주, 제시치료구역발생응고성배사.이최종진단위금표준, 초성조영대종류멸활진단적준학성고우상규채초(90.6% vs 46.9%,P <0.05).결론:초성조영능준학판단HIFU대종류소융범위급정도, 위HCC환자HIFU치료후적조기료효평개제공의거.
AIM: To evaluate the role of contrast-enhanced ultrasonography in assessing the short-term therapeutic response of hepatocellular carcinoma with high intensity focused ultrasound (HIFU). METHODS: Thirty two patients with hepatocellular carcinoma (HCC) received HIFU treatments including 23 part-covered treatments and 9 full-covered treatments. Contrast-enhanced ultrasound (CEUS) imaging was performed to monitor the response of tumor vessels to HIFU ablation before the treatment and 1-4 d after the treatment separately. Simultaneously, all patients underwent routine US for comparison. RESULTS: Compared with tumor images in the patients before HIFU which showed multiple blood flow signals, clinical images showed an abrupt interruption, followed by the cessation of blood flow within the tumor vessels after HIFU treatment, demonstrating that homogeneous coagulative necrosis occurred in the treatment area. According to the final diagnosis as gold standard, the accuracy of CEUS for HIFU was much better than the conventional ultrasonography (90.6% vs 46.9%, P < 0.05). CONCLUSION: CEUS can accurately differentiate tumor necrosis and evaluate therapeutic efficacy of HIFU.