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超声造影在肝细胞癌射频消融中的疗效

Efficacy of contrast-enhanced ultrasonography in radiofrequency ablation for hepatocellular carcinoma.

作者信息

Dohmen Takahiro, Kataoka Ei, Yamada Ikuhiro, Miura Kouichi, Ohshima Shigetoshi, Shibuya Tomomi, Segawa Daisuke, Sato Wataru, Anezaki Yumiko, Ishii Hajime, Kamada Kentaro, Goto Takashi, Ohnishi Hirohide

机构信息

Department of Gastroenterology, Akita University Graduate School of Medicine, Japan.

出版信息

Intern Med. 2012;51(1):1-7. doi: 10.2169/internalmedicine.51.6042. Epub 2012 Jan 1.

Abstract

OBJECTIVE

Local recurrence after radiofrequency ablation (RFA) is a major problem that needs to resolved to increase the survival rate of hepatocellular carcinoma (HCC). CE-US with Sonazoid(®), the second-generation contrast media, can detect smaller HCC lesions and the detection rate of ultrasonically unrecognized hypervascular HCC was improved by CE-US. The aim of the present study was to evaluate the role of CE-US with Sonazoid(®) in improving radicality and reducing local recurrence after RFA for HCC.

PATIENTS AND METHODS

A total of 102 nodules treated by RFA at our hospital from January 2006 to October 2009 were enrolled: 31 nodules were treated without CE-US, since CE-US was not yet available (Group A), and 71 nodules were treated with a combination of RFA and CE-US with Sonazoid(®) (Group B).

RESULTS

The clinical characteristics (sex, virus marker, Child-Pugh grade, with or without transcatheter arterial infusion chemotherapy with lipiodol, and T factor) did not differ significantly between group A and group B. Mean age was significantly older and tumor size was significantly larger in group B. Group B had significantly better radicality compared with group A. The non-local recurrence rate was significantly higher in group B as compared with group A.

CONCLUSION

CE-US with Sonazoid(®) greatly helps to improve RFA efficacy in HCC treatment. We suggest that the ability of CE-US with Sonazoid(®) to detect an accurate area of HCC before RFA and to immediately detect a residual tumor during RFA might contribute to an increase of the radicality and reduction of local recurrence after RFA.

摘要

目的

射频消融(RFA)后局部复发是一个需要解决的主要问题,以提高肝细胞癌(HCC)的生存率。使用第二代造影剂声诺维(Sonazoid®)的超声造影(CE-US)能够检测出更小的HCC病灶,且提高了超声未识别的高血供HCC的检出率。本研究的目的是评估使用声诺维(Sonazoid®)的CE-US在提高HCC患者RFA术后根治性及降低局部复发方面的作用。

患者与方法

纳入2006年1月至2009年10月在我院接受RFA治疗的102个结节:31个结节在CE-US尚不可用时未使用CE-US进行治疗(A组),71个结节采用RFA联合使用声诺维(Sonazoid®)的CE-US进行治疗(B组)。

结果

A组和B组的临床特征(性别、病毒标志物、Child-Pugh分级、有无经动脉碘油化疗及T分期)差异无统计学意义。B组的平均年龄显著更大,肿瘤大小显著更大。B组的根治性明显优于A组。B组的非局部复发率显著高于A组。

结论

使用声诺维(Sonazoid®)的CE-US极大地有助于提高HCC治疗中RFA的疗效。我们认为,使用声诺维(Sonazoid®)的CE-US在RFA前准确检测HCC区域以及在RFA过程中立即检测残留肿瘤的能力可能有助于提高RFA术后的根治性并降低局部复发率。

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