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目的 观察Levovist声学造影判断射频消融治疗肝癌局部疗效的长期结果,探讨声学造影在局部疗效判断中的目的 观察Levovist声学造影判断射频消融治疗肝癌局部疗效的长期结果,探讨声学造影在局部疗效判断中的意义。 方法 对 23例肝癌(25个结节)射频消融治疗后行增强CT扫描和Levovist超声造影检查,以增强CT结果作为判断是否完全消融的标准,决定是否追加治疗。追踪 21~42个月观察局部复发情况,比较超声造影和增强CT对局部疗效判断的准确性。 结果 治疗 1个月后超声造影检出 8个有血流的结节, CT检出 5个结节有血供,超声造影与CT比较对瘤内血流检出的敏感性为 75%,特异性、准确性均为 76 %,假阳性 5例,假阴性 1例。但追踪观察 21~42个月后发现 5个超声造影阳性、CT增强阴性结节中的 4个于治疗后 3~15个月复发,其余超声造影和CT增强扫描均阴性的结节和CT增强为阳性经过再治疗的结节均未见复发。 结论 与CT比较,Levovist声学造影对瘤内血流检测有可能更敏感,声学造影阳性而CT增强为阴性的结节强烈提示有局部复发的可能,有严密观察或追加治疗的必要。
Objective To observe the long-term results of Levovist’s acoustic radiography in evaluating the local efficacy of radiofrequency ablation in the treatment of hepatocellular carcinoma and to explore the long-term results of radiofrequency ablation in assessing the local efficacy of radiofrequency ablation in the assessment of local curative effect. significance. Methods Twenty-three patients with hepatocellular carcinoma (25 nodules) underwent radiofrequency ablation (CT) and Levovist contrast-enhanced ultrasound (CEUS) to enhance CT findings as a criterion for determining complete ablation and decide whether to add additional treatment. Follow-up 21 to 42 months to observe the local recurrence, compared with contrast-enhanced ultrasound and CT to determine the accuracy of local efficacy. Results One month after the treatment, 8 blood-flow nodules were detected by contrast-enhanced ultrasound and 5 nodules were detected by CT. The sensitivity of contrast-enhanced ultrasonography and CT in detection of intracranial blood flow was 75% Both sex and accuracy were 76%, false positive in 5 cases and false negative in 1 case. However, after follow-up observation of 21 to 42 months, 5 contrast-enhanced ultrasound findings were found, 4 of the CT-enhanced negative nodules relapsed 3 to 15 months after the treatment, and the remaining nodules and CT enhancement were negative in all other contrast-enhanced and CT-enhanced scans No recurrence was found in nodules that were positive after re-treatment. Conclusion Compared with CT, Levovist angiography may be more sensitive to the detection of intratumoral blood flow. The nodules with positive acoustic contrast and negative CT enhancement strongly suggest the possibility of local recurrence, and the need for close observation or additional treatment.