使用声诺维通过超声造影引导的消融治疗用于常规超声未检测到的肝细胞癌病灶。

Ablation therapy guided by contrast-enhanced sonography with Sonazoid for hepatocellular carcinoma lesions not detected by conventional sonography.

作者信息

Numata Kazushi, Morimoto Manabu, Ogura Takashi, Sugimori Kazuya, Takebayashi Shigeo, Okada Masahiro, Tanaka Katsuaki

机构信息

Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Kanagawa 232-0024, Japan.

出版信息

J Ultrasound Med. 2008 Mar;27(3):395-406. doi: 10.7863/jum.2008.27.3.395.

DOI:10.7863/jum.2008.27.3.395

PMID:18314518

Abstract

OBJECTIVE

We evaluated the usefulness of contrast-enhanced harmonic gray scale sonography with a newly developed sonographic contrast medium as a means of guidance for percutaneous ablation therapy of hepatocellular carcinoma lesions not detected by conventional sonography.

METHODS

We examined 85 patients with 108 hepatocellular carcinoma lesions that were identified as hypervascular by multidetector-row computed tomography by using contrast-enhanced harmonic gray scale sonography after injection of Sonazoid (GE Healthcare, Oslo, Norway), a lipid-stabilized suspension of a perfluorobutane gas microbubble contrast agent. We scanned the whole liver by this modality at a low mechanical index in the late phase to detect lesions not detected by conventional sonography and then scanned the lesions again by this modality at a high mechanical index to visualize tumor vessels and enhancement. We also performed percutaneous ablation therapy guided by this modality to treat viable hepatocellular carcinoma lesions that could not be detected by conventional sonography.

RESULTS

Conventional sonography identified 90 (83%) of 108 hepatocellular carcinoma lesions; 15 (14%) additional viable lesions not detected by conventional sonography were detected in the late phase of contrast-enhanced harmonic gray scale sonography at a low mechanical index, and tumor vessels and enhancement were observed in the late phase at a high mechanical index. Contrast-enhanced harmonic gray scale sonography diagnosed 105 (97%) of the 108 viable hepatocellular carcinoma lesions, and 14 (93%) of the 15 lesions not detected by conventional sonography were successfully treated by percutaneous ablation therapy guided by this modality.

CONCLUSIONS

Contrast-enhanced harmonic gray scale sonography is useful for guidance of percutaneous ablation therapy of hepatocellular carcinoma lesions not detected by conventional sonography.

摘要

目的

我们评估了使用一种新开发的超声造影剂的超声造影谐波灰阶成像在引导经皮消融治疗常规超声未检测到的肝细胞癌病灶方面的有效性。

方法

我们对85例患者的108个肝细胞癌病灶进行了检查，这些病灶经多排探测器计算机断层扫描显示为高血供。在注射Sonazoid（通用电气医疗集团，挪威奥斯陆）后，使用超声造影谐波灰阶成像，Sonazoid是一种全氟丁烷气体微泡造影剂的脂质稳定悬浮液。我们在晚期以低机械指数通过这种方式扫描整个肝脏，以检测常规超声未检测到的病灶，然后在高机械指数下再次通过这种方式扫描病灶，以显示肿瘤血管和强化情况。我们还在这种方式的引导下进行经皮消融治疗，以治疗常规超声无法检测到的存活肝细胞癌病灶。

结果

常规超声检测出108个肝细胞癌病灶中的90个（83%）；在超声造影谐波灰阶成像晚期以低机械指数检测到另外15个（14%）常规超声未检测到的存活病灶，在高机械指数下的晚期观察到肿瘤血管和强化情况。超声造影谐波灰阶成像诊断出108个存活肝细胞癌病灶中的105个（97%），在这种方式引导下的经皮消融治疗成功治疗了15个常规超声未检测到的病灶中的14个（93%）。