Koito K, Namieno T, Ichimura T, Hirokawa N, Syonai T, Hareyama M, Katsuramaki T, Hirata K, Nishi M
Department of Radiology, Sapporo Medical University, Japan.
AJR Am J Roentgenol. 2000 Feb;174(2):337-41. doi: 10.2214/ajr.174.2.1740337.
The aim of this study was to compare tumor detectability by assessing the vascularity on power and color Doppler sonography and CT after transarterial embolization or percutaneous ethanol injection therapy or both in hepatocellular carcinoma.
Forty-seven nodules of hepatocellular carcinoma (size, 28 +/- 7 mm [mean +/- standard deviation]; range, 20-40 mm) in 38 patients were treated with transarterial embolization (n = 6), percutaneous ethanol injection therapy (n = 23), and transarterial embolization plus percutaneous ethanol injection therapy (n = 9). Power Doppler sonography, color Doppler sonography, and CT were performed before and 2 weeks, 3 months, and 6 months after the treatments. The existence of hepatocellular carcinoma was confirmed by positive findings for color signals on both Doppler sonography techniques and for tumor stains on CT. All the tumors were determined to be malignant by microscopic examination of biopsy specimens.
Before the treatments, power Doppler sonography (100%) and CT (100%) were significantly more effective than color Doppler sonography (61.7%) (p < 0.001, for both). Six months after the treatments, the sensitivity of power Doppler sonography (87.5%) was significantly better than that of color Doppler sonography (12.5%) but was not significant in comparison with CT (66.6%). However, power Doppler sonography detected color signals in two of three tumors in which iodized oil was accumulated and no tumor stain appeared on CT, and the two lesions detected with power Doppler sonography were carcinomas.
Power Doppler sonography can be considered the most sensitive technique in assessing the viability of hepatocellular carcinoma treated with transarterial embolization or percutaneous ethanol injection therapy or both.
本研究旨在通过评估经动脉栓塞术、经皮乙醇注射疗法或两者联合治疗肝细胞癌后，利用能量多普勒超声、彩色多普勒超声及CT检查肿瘤血管情况，比较肿瘤的可检测性。
38例患者的47个肝细胞癌结节（大小为28±7mm[平均值±标准差]；范围为20 - 40mm）接受了经动脉栓塞术（n = 6）、经皮乙醇注射疗法（n = 23）以及经动脉栓塞术联合经皮乙醇注射疗法（n = 9）。在治疗前、治疗后2周、3个月及6个月分别进行能量多普勒超声、彩色多普勒超声及CT检查。通过多普勒超声技术上的彩色信号阳性发现以及CT上的肿瘤染色来确认肝细胞癌的存在。所有肿瘤均经活检标本的显微镜检查确定为恶性。
治疗前，能量多普勒超声（100%）和CT（100%）的有效性显著高于彩色多普勒超声（61.7%）（两者p均<0.001）。治疗6个月后，能量多普勒超声的敏感性（87.5%）显著优于彩色多普勒超声（12.5%），但与CT（66.6%）相比无显著差异。然而，能量多普勒超声在3个碘油积聚且CT上无肿瘤染色的肿瘤中的2个检测到了彩色信号，经能量多普勒超声检测到的这2个病变为癌。
在评估经动脉栓塞术、经皮乙醇注射疗法或两者联合治疗的肝细胞癌的存活情况时，能量多普勒超声可被认为是最敏感的技术。
