Hirooka Masashi, Iuchi Hidehito, Kumagi Teru, Shigematsu Shuichiro, Hiraoka Atsushi, Uehara Takahide, Kurose Kiyotaka, Horiike Norio, Onji Morikazu
Third Department of Internal Medicine, Ehime University, Sigenobutyo Sizukawa, Ehime, Japan.
AJR Am J Roentgenol. 2006 May;186(5 Suppl):S255-60. doi: 10.2214/AJR.04.1252.
Some nodules cannot be visualized clearly on conventional sonography but can be visualized on CT. In the present study, we evaluated the usefulness of real-time percutaneous ablation therapy under virtual sonographic guidance for these nodules.
In vitro experiments were performed with gelatin gel to evaluate the accuracy of virtual sonography. We also studied 50 patients with 58 hepatocellular carcinoma nodules, of whom 18 patients (21 nodules) underwent radiofrequency ablation by virtual sonography. This was the initial treatment for seven of these patients and an additional treatment for 11 patients. Thirty-two patients (37 nodules) received radiofrequency ablation without virtual imaging. The patients receiving standard radiofrequency ablation were retrospectively selected as the historical control group under the same conditions as the study group.
The in vitro gelatin gel study revealed that all punctures had been performed accurately. In both the initial-treatment group and the additional-treatment group, the mean number of treatments with virtual sonography was significantly lower than that without virtual sonography (p = 0.003 for both groups). The rates of local recurrence and complications did not differ significantly between the two groups.
In the treatment of nodules not depicted on sonography, radiofrequency ablation assisted by virtual sonography is an efficacious alternative.
一些结节在传统超声检查中无法清晰显示，但在CT上可以显示。在本研究中，我们评估了虚拟超声引导下实时经皮消融治疗这些结节的有效性。
用明胶凝胶进行体外实验以评估虚拟超声的准确性。我们还研究了50例患有58个肝细胞癌结节的患者，其中18例患者（21个结节）通过虚拟超声进行了射频消融。这是其中7例患者的初始治疗，11例患者的额外治疗。32例患者（37个结节）接受了无虚拟成像的射频消融。接受标准射频消融的患者在与研究组相同的条件下被回顾性地选为历史对照组。
体外明胶凝胶研究表明所有穿刺均准确进行。在初始治疗组和额外治疗组中，虚拟超声的平均治疗次数均显著低于无虚拟超声的情况（两组均p = 0.003）。两组之间的局部复发率和并发症发生率无显著差异。
在治疗超声未显示的结节时，虚拟超声辅助的射频消融是一种有效的替代方法。
