Kono Yuko, Lucidarme Olivier, Choi Sang-Hee, Rose Steven C, Hassanein Tarek I, Alpert Elliot, Mattrey Robert F
Department of Radiology, University of California, San Diego, San Diego, CA 92103-8756, USA.
J Vasc Interv Radiol. 2007 Jan;18(1 Pt 1):57-65. doi: 10.1016/j.jvir.2006.10.016.
To determine whether contrast-enhanced ultrasound (CEUS) can aid in assessing treatment efficacy within the first 2 weeks after transarterial chemoembolization for hepatocellular carcinoma.
Contrast-enhanced ultrasound was performed to detect residual tumor blood flow after 42 transarterial chemoembolization procedures in 33 patients who had hepatocellular carcinomas, and the results were compared with final tumor outcome. Twenty-nine CEUS studies were performed within 2 weeks after treatment and the remainder within 1 month. Phase-inversion low-mechanical-index real-time and intermittent imaging were performed after the intravenous injection of 0.5-2 mL US contrast medium by experienced radiologists blind to all other imaging findings.
Nine tumors did not reach final outcome--patients were lost to follow-up or died without autopsy (n = 6) or tumors were retreated before final outcome was established (n = 3). Of the remaining 33 tumors, outcome was established by histology (n = 9), angiography (n = 14), tumor growth (n = 2), or by computed tomography and/or magnetic resonance imaging performed more than 6 months after treatment (n = 8). Twenty-three tumors were studied by CEUS within 2 weeks and 10 within 1 month after treatment. Of these 33 tumors, there were no false-negative results and one false-positive result. The only error occurred when the CEUS study was performed within 1 day after treatment.
Residual tumor blood flow on CEUS performed at 2 or more days after transarterial chemoembolization may be predictive of tumor outcome that currently requires 3 months to be reliably detected by computed tomography and/or magnetic resonance imaging.
确定超声造影（CEUS）是否有助于评估肝细胞癌经动脉化疗栓塞术后2周内的治疗效果。
对33例肝细胞癌患者进行42次经动脉化疗栓塞术后，采用超声造影检测残余肿瘤血流，并将结果与最终肿瘤结局进行比较。29例超声造影检查在治疗后2周内进行，其余在1个月内进行。由对所有其他影像学检查结果不知情的经验丰富的放射科医生在静脉注射0.5 - 2 mL超声造影剂后进行相位反转低机械指数实时和间歇成像。
9个肿瘤未得出最终结局——患者失访或未进行尸检死亡（n = 6），或在确定最终结局之前对肿瘤进行了再次治疗（n = 3）。在其余33个肿瘤中，通过组织学（n = 9）、血管造影（n = 14）、肿瘤生长情况（n = 2）或治疗后6个月以上进行的计算机断层扫描和/或磁共振成像（n = 8）确定结局。23个肿瘤在治疗后2周内进行了超声造影检查，10个在治疗后1个月内进行了检查。在这33个肿瘤中，没有假阴性结果，有1例假阳性结果。唯一的错误发生在治疗后1天内进行超声造影检查时。
经动脉化疗栓塞术后2天或更长时间进行的超声造影上的残余肿瘤血流可能预示肿瘤结局，而目前通过计算机断层扫描和/或磁共振成像可靠检测该结局需要3个月时间。
