CAJ | 학술논문

目的：观察肝细胞性肝癌（hepatocellular carcinoma, HCC）施行经皮肝动脉栓塞化疗（transcatheter arterial chemoembolization , TACE）治疗后的超声造影（contrast-enhanced ultrasound , CEUS）表现，并探讨超声造影定量分析评价肝细胞性肝癌施行治疗后残留/复发灶的临床应用价值。方法对42例HCC患者共47个病灶行TACE治疗，在低机械指数状态下进行实时CEUS，并进行评价疗效；采用时间-强度量化分析软件检测治疗后残留病灶内血流灌注的信息。结果HCC病人施行TACE治疗后，超声造影显示，8个病灶三期无增强，39个病灶局部有增强。以同期DSA结果为对照标准，超声造影诊断TACE治疗后残留/复发的灵敏度为97.4%，特异度为87.5%，准确度为95.7%。CEUS时间-强度量化分析表明，38个残留、复发灶治疗前后，增强强度与达峰时间差异有统计学意义（P<0.05）。结论CEUS可以作为HCC病人TACE治疗的疗效评估的可靠方法，时间-强度量化分析有助于客观评价残留/复发灶的血供。
목적：관찰간세포성간암（hepatocellular carcinoma, HCC）시행경피간동맥전새화료（transcatheter arterial chemoembolization , TACE）치료후적초성조영（contrast-enhanced ultrasound , CEUS）표현，병탐토초성조영정량분석평개간세포성간암시행치료후잔류/복발조적림상응용개치。방법대42례HCC환자공47개병조행TACE치료，재저궤계지수상태하진행실시CEUS，병진행평개료효；채용시간-강도양화분석연건검측치료후잔류병조내혈류관주적신식。결과HCC병인시행TACE치료후，초성조영현시，8개병조삼기무증강，39개병조국부유증강。이동기DSA결과위대조표준，초성조영진단TACE치료후잔류/복발적령민도위97.4%，특이도위87.5%，준학도위95.7%。CEUS시간-강도양화분석표명，38개잔류、복발조치료전후，증강강도여체봉시간차이유통계학의의（P<0.05）。결론CEUS가이작위HCC병인TACE치료적료효평고적가고방법，시간-강도양화분석유조우객관평개잔류/복발조적혈공。
Objective To observe the characteristics of contrast-enhanced ultrasound on patients with hepatocellular carcinoma(HCC) underwent transcatheter arterial chemoembolization(TACE)and to explore the value of time-intensity parameters of contrast-enhanced ultrasound(CEUS) for residual and recurrent viable tumor blood supply for the patients with HCC after TACE. Methods The therapeutic effects on quantitative analysis of contrast-enhanced ultrasound on 42 HCC patients with 47 tumor lesions underwent CEUS examination after TACE were evaluated. The residual and recurrent viable tumor blood supply parameters after TACE were analyzed by means of time-intensity curve of CEUS. Results The CEUS examination showed that the residual and recurrent viable tumors have enhancement in 39 lesions and have not identify enhancement in any of the remaining 8 lesions for the HCC patients after TACE .Compared with DSA , the sensitivity rate, specifity and accuracy rate of CEUS in the diagnosis for the patients with HCC after TACE was 97.4%,87.5%,95.7%respectively.Time-intensity curve of CEUS showed that the arrival time and enhanced intensity were statistically different in the HCC patients after TACE with 38 residual and recurrent viable tumors.(P<0.05). Conclusions The CEUS examination could be a useful and effective technique for evaluation of the therapeutic effects on the patients with HCC. The quantitative analysis of time-intensity on CEUS is helpful for the evaluation and analysis of residual tumor blood supply .