中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Issue 8
Aug.  2018
Turn off MathJax
Article Contents

Application of contrast-enhanced ultrasound in microwave ablation of small hepatocellular carcinoma difficult to display on conventional ultrasonography

DOI: 10.3969/j.issn.1001-5256.2018.08.021
Research funding:

 

  • Received Date: 2018-03-12
  • Published Date: 2018-08-20
  • Objective To investigate the value of contrast-enhanced ultrasound in microwave ablation of small hepatocellular carcinoma difficult to display on conventional ultrasonography. Methods A retrospective analysis was performed for the clinical data of the patients with liver cancer difficult to display on conventional ultrasonography who were treated in Department of Oncology in General Hospital of Chengdu Military Region from January 2015 to December 2017, and according to the results of contrast-enhanced computed tomography ( CT) , all patients had a nodule diameter of < 3. 0 cm. All patients were given contrast-enhanced ultrasound during microwave ablation to identify tumor location and size. Contrast-enhanced CT was performed at one month after surgery to evaluate the effect of ablation and the incidence of complications. For each lesion, conventional ultrasound images and contrast-enhanced CT images before surgery, contrast-enhanced ultrasound images during surgery, and contrast-enhanced CT images after surgery were analyzed to evaluate treatment outcome and postoperative follow-up. Results A total of 52 patients with 78 lesions were enrolled. Of all lesions, 73 were directly displayed on contrast-enhanced ultrasound and 5 were clarified in combination with contrast-enhanced CT, among which one was located near the diaphragm and the top of the liver and four were only slightly enhanced in the arterial phase on contrast-enhanced ultrasound. Microwave ablation was performed for all 78 lesions, and no major complications were observed. Follow-up at one month after surgery showed that all 78 lesions were completely inactivated. Conclusion Contrast-enhanced ultrasound can clearly show the location, size, and extent of infiltration of small hepatocellular carcinoma lesions which are difficult to display on conventional ultrasonography. It also helps with accurate localization for microwave ablation and has fewer complications. Therefore, it is an important auxiliary method for microwave ablation.

     

  • loading
  • [1]YANG P, ZHANG EL, XIAO ZY, et al.Therapeutic outcomes of surgical resection versus percutaneous microwave coagulation therapy for single small hepatocellular carcinoma with cirrhosis (250 cases) [J].Acta Med Univ Sci Technol Huazhong, 2016, 45 (2) :185-189. (in Chinese) 杨藩, 张二雷, 肖震宇, 等.经皮微波消融与手术切除治疗合并肝硬化的单发小肝癌的疗效比较 (附250例) [J].华中科技大学学报:医学版, 2016, 45 (2) :185-189.
    [2]HUANG Y, CHEN J, LIU XS.Clinical efficacy of laparoscopic microwave ablation in the treatment of small hepatocellular carcinoma with cirrhosis[J].Chin J Min Inv Surg, 2017, 17 (6) :504-508. (in Chinese) 黄炎, 陈坚, 刘绪舜.腹腔镜微波消融治疗小肝癌合并肝硬化的临床疗效[J].中国微创外科杂志, 2017, 17 (6) :504-508.
    [3]CHEN Y, ZHOU J, FAN J, et al.Clinical effect and prognostic factors analysis of intraoperative radiofrequency ablation in treatment of hepatocellular carcinoma with severe cirrhosis[J].Chin J Dig Surg, 2017, 16 (2) :159-163. (in Chinese) 陈漪, 周俭, 樊嘉, 等.术中射频消融治疗合并重度肝硬化肝细胞癌的临床疗效及预后因素分析[J].中华消化外科杂志, 2017, 16 (2) :159-163.
    [4]CHENG HY.Interventional treatment for hepatocellular carcinoma:A review of current status and perspectives[J].J Clin Hepatol, 2016, 32 (1) :3-8. (in Chinese) 程红岩.肝癌介入治疗的现状与展望[J].临床肝胆病杂志, 2016, 32 (1) :3-8.
    [5]DU L, HOU LC, ZHANG LQ, et al.Application of microwave ablation in treatment of solid space-occupying lesions in the liver[J].J Clin Hepatol, 2017, 33 (10) :2030-2034. (in Chinese) 杜磊, 侯立朝, 张灵强, 等.微波消融在肝脏实性占位病变治疗中的应用[J].临床肝胆病杂志, 2017, 33 (10) :2030-2034.
    [6]LI JS, LOU KX, HAN L, et al.Evaluation of contrast-enhanced ultrasound guided microwave ablation for the treatment of advanced hepatic malignant tumors[J].China Med Herald, 2016, 13 (17) :82-85. (in Chinese) 李劲松, 娄可新, 韩亮, 等.超声造影引导下微波消融治疗晚期肝脏恶性肿瘤的临床观察[J].中国医药导报, 2016, 13 (17) :82-85.
    [7]DENG Y, LI KY, XU F, et al.Association of histopathologic grading and contrast-enhanced ultrasound in hepatocellular carcinoma[J].Chin J Interv Imaging Ther, 2009, 6 (2) :120-123. (in Chinese) 邓远, 李开艳, 徐芬, 等.原发性肝细胞肝癌组织分化程度与超声造影的关系[J].中国介入影像与治疗学, 2009, 6 (2) :120-123.
    [8]JI ZB, WANG WP, YU Q, et al.Contrast enhanced ultrasonography in the characterization of focal liver lesions before microwave ablation therapy[J].Chin J Interv Imaging Ther, 2010, 7 (1) :19-21. (in Chinese) 季正标, 王文平, 俞清, 等.肝癌微波消融术前超声造影对肝脏肿瘤再定性的应用价值[J].中国介入影像与治疗学, 2010, 7 (1) :19-21.
    [9]KIM AY, LEE MW, RHIM H, et al.Pretreatment evaluation with contrast-enhanced ultrasonography for percutaneous radio-frequency ablation of hepatocellular carcinomas with poor con-spicuity on conventional ultrasonography[J].Korean J Radiol, 2013, 14 (5) :754-763.
    [10]WESTWOOD M, JOORE M, GRUTTERS J, et al.Contrast-enhanced ultrasound using Sono Vue (sulphur hexafluoride microbubbles) compared with contrast-enhanced computed tomography and contrast-enhanced magnetic resonance imaging for the characterisation of focal liver lesions and detection of liver metastases:A systematic review and cost-effectiveness analysis[J].Health Technol Assess, 2013, 17 (16) :1-243.
    [11]DAI GY, DAI L, LIU Z, et al.Investigation of efficacy of virtual navigation contrast enhanced sonography during microwave ablation of small liver tumors undetectable by conventional sonography[J].J Pract Med, 2017, 33 (21) :3643-3646. (in Chinese) 戴戈扬, 戴琳, 刘志, 等.虚拟导航超声造影指导常规超声不能检出肝脏小占位病灶微波消融术的精准定位研究[J].实用医学杂志, 2017, 33 (21) :3643-3646.
    [12]SIMON CJ, DUPUY DE, MAYO-SMITH WW.Microwave ablation:Principles and applications[J].Radiographics, 2005, 25:s69-s83.
    [13]LI XH, LIU JJ, LI H, et al.A study on contrast-enhanced ultrasound value of the treatment on special part liver cancer[J].Chin J Ultrasound Med, 2016, 32 (1) :37-39. (in Chinese) 李红学, 刘军杰, 李航, 等.超声造影在特殊部位肝癌治疗中的价值[J].中国超声医学杂志, 2016, 32 (1) :37-39.
    [14]SU X, LIU YJ, LI B.Percutaneous microwave ablation for the treatment of small liver cancer:Analysis of 31 clinical cases[J].China Health Stand Manag, 2016, 7 (15) :86-88. (in Chinese) 苏旭, 刘育健, 李滨.经皮微波消融术治疗小肝癌31例临床分析[J].中国卫生标准管理, 2016, 7 (15) :86-88.
    [15]YAN SY, ZHANG Y, SUN C, et al.Comparison of real-time contrast-enhanced ultrasonography and standard ultrasonography in liver cancer microwave ablation[J].Exp Ther Med, 2016, 12 (3) :1345-1348.
    [16]HUANG B, XUN YH, LIU DL, et al.Clinical effect of percutaneous microwave coagulation in treatment of primary liver cancer at special locations[J].Zhejiang Clin Med J, 2017, 19 (6) :1019-1023. (in Chinese) 黄斌, 荀运浩, 刘德林, 等.特殊部位原发性肝癌经皮微波消融临床观察[J].浙江临床医学, 2017, 19 (6) :1019-1023.
    [17]YANG XH.Prospectively multi-center study of ultrasound—guided Percutaneous cooled-probe microwave ablation for Early——stage Primary Liver Cancer[D].Beijing:Med Sch Chin PLA, 2016. (in Chinese) 杨晓环.超声引导下经皮微波消融治疗早期原发性肝癌的前瞻性多中心研究[D].中国人民解放军医学院, 2016.
    [18]CUI X, LI KY, LUO HC, et al.Ultrasound-guided percutaneous microwave ablation of hepatic cancer in special parts[J].J Clin Ultrasound in Med, 2012, 14 (5) :313-316. (in Chinese) 崔贤, 李开艳, 罗鸿昌, 等.超声引导经皮微波消融治疗特殊部位肝癌[J].临床超声医学杂志, 2012, 14 (5) :313-316.
    [19]QIAO Q, LI HY, WU J, et al.Radiofrequency ablation and microwave ablation under artificial ascites for hepatocellular carcinoma adjacent to vital organs[J].Chin J Min Inv Surg, 2016, 16 (8) :724-727. (in Chinese) 乔强, 李海莹, 吴佳恒, 等.人工腹水下射频消融和微波消融治疗毗邻重要器官的肝癌[J].中国微创外科杂志, 2016, 16 (8) :724-727.
    [20]FANG HP, PAN WD, LIN N, et al.Application of thermalablation with artificial ascites for liver cancer located in privileged sites of hepatobiliary[J/CD].Chin J Clinicians:Electronic Edition, 2009, 3 (7) :1106-1112. (in Chinese) 方和平, 潘卫东, 林楠, 等.腹腔镜下人工胸、腹水在特殊部位肝癌热消融中的应用[J/CD].中华临床医师杂志:电子版, 2009, 3 (7) :1106-1112.
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Article Metrics

    Article views (278) PDF downloads(95) Cited by()
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return