Chen M H, Yang W, Yan K, Dai Y, Wu W, Fan Z H, Callstrom M R, Charboneau J W
Ultrasound Department, School of Oncology, Peking University, Hai Dian District, Beijing 100036, China.
Clin Radiol. 2007 Aug;62(8):752-60. doi: 10.1016/j.crad.2006.12.013. Epub 2007 Jun 4.
To evaluate the clinical value of contrast-enhanced ultrasound (CEUS) for patients with hepatocellular carcinoma (HCC) in identifying the tumour number, ablation range and feeding vessels before ultrasound-guided radiofrequency ablation (RFA), and to compare the efficacy of RFA after CEUS with the efficacy of RFA after non-enhanced ultrasonography (US) without contrast medium administration.
From 2002 to 2005, 81 patients with 110 HCCs underwent CEUS with SonoVue before RFA treatment (group A). Eighty six patients with 112 HCCs who underwent US without contrast enhancement before RFA served as the control group (group B). The average diameters of the lesions in group A and group B were 3.6+/-1.1cm and 3.5+/-1.1cm, respectively. There were no significant differences in clinical data between the two groups. Regular follow-up after treatment was performed using contrast-enhanced computed tomography (CECT). After treatment, complete necrosis was defined as the absence of viable tissue in treated tumours at the 1-year follow-up CECT.
Using CEUS an additional seven small lesions (< or =2.0 cm) were found compared with those found using CECT and conventional US. CEUS showed that 56.4% of lesions (62/110 tumours) were larger in size and 49.1% (54/110 tumours) became more irregular in shape during the arterial phase than on conventional US. Feeding vessels were detected using CEUS in 52 (91.2%) of 57 lesions that were larger than 3.5 cm. The follow-up period was at least 1 year for each case. The complete tumour necrosis rate in group A was significantly higher than that in group B (92.2% versus 83.0%; p=0.036).
CEUS can be used to more accurately define the size and contour of lesions, and to detect additional small or satellite lesions and the feeding vessel of HCC tumours. CEUS provided important information for designing the ablation protocol, and might improve the efficacy of RFA.
评估超声造影（CEUS）对肝细胞癌（HCC）患者在超声引导下射频消融（RFA）术前确定肿瘤数目、消融范围及供血血管的临床价值，并比较CEUS引导下RFA与未使用造影剂的非增强超声（US）引导下RFA的疗效。
2002年至2005年，81例患有110个HCC的患者在RFA治疗前接受了使用声诺维的CEUS检查（A组）。86例患有112个HCC的患者在RFA前接受了非增强超声检查作为对照组（B组）。A组和B组病变的平均直径分别为3.6±1.1cm和3.5±1.1cm。两组临床资料无显著差异。治疗后采用增强CT（CECT）进行定期随访。治疗后，完全坏死定义为在1年随访CECT时治疗的肿瘤中无存活组织。
与CECT和传统US相比，使用CEUS发现了另外7个小病变（≤2.0cm）。CEUS显示，56.4%的病变（62/110个肿瘤）在动脉期比传统US显示的尺寸更大，49.1%（54/110个肿瘤）形状变得更不规则。在57个大于3.5cm的病变中，CEUS检测到52个（91.2%）的供血血管。每例患者的随访期至少为1年。A组的肿瘤完全坏死率显著高于B组（92.2%对83.0%；p = 0.036）。
CEUS可用于更准确地确定病变的大小和轮廓，检测额外的小病变或卫星病变以及HCC肿瘤的供血血管。CEUS为设计消融方案提供了重要信息，并可能提高RFA的疗效。
