| Objectives Using the contrast-enhanced imaging technology,to observe the enhanced and fading during three phase internal and peripheral of the large liver cancer’s after high intensity focused ultrasound treatment through comparing the performance before treatment,then we can judge inactivated or residue. comparing with enhanced CT, to explore its application value in the evaluation of the recent curative effect.in large liver cancer after high intensity focused ultrasound treatmentMethods 28 patients with the liver were selected who were unfavorable for surgery, radiotherapy or were unwilling to accept the surgical treatment between October 2013 and October 2014 from oncology of our hospital. all patients have done two or more than two kinds of imaging examination and serological examination or have done biopsy pathology diagnosis, male 22 cases, female 6 cases, aged 35 to 82 years old, the average age of 53, of which 23 cases were primary liver cancer, 5 cases were metastatic liver cancer, all lesions were examed with two-dimensional 、 color doppler ultrasound imaging and contrast-enhanced ultrasound examination before high intensity focused ultrasound treatment,in order to make clear lesions number, size, location, internal blood flow conditions and contrast enhancement pattern, at the same time enhancement CT examination were done, the results were recorded respectively by different researchers,contrast-enhanced ultrasound results need to be analyzed by doctors jointly working more than five years in contrast-enhanced ultrasound examination, and after 1~3 days the examination of the conventional ultrasound and contrast-enhanced ultrasound were done, once discover residual lesions with contrast-enhanced ultrasound examination,high intensity focused ultrasound supplementation,done in a timely manner. One months later, all lesions respectively done enhanced CT examination and contrast-enhanced ultrasound to evaluate the efficacy, we done needle biopsy for which were inconsistent with diagnosis between contrast enhancd ultrasound and enhaced CT, at last,the biopsy results as the gold standard, to determine thecontrast-enhanced ultrasound in evaluating the effect of high intensity focused ultrasound treatment of liver cancer in the near future.Results Before treatment, the conventional two-dimensional ultrasound found suspicious malignant lesions 35, the contrast-enhanced ultrasound found malignant lesions 41,40 malignant tumors can be detected with enhancement CT, in the diagnosis of liver cancer and the qualitative aspect, contrast-enhanced ultrasound is superior to the conventional ultrasound, while has a good consistency with enhanced CT. we selected 33 lesions of the largest diameter during 3 to 10 cm for high intensity focused ultrasound treatment..After treatment of 1~3 days, contrast-enhanced ultrasound examination showed that twelve melted completely, which tumor within the focal perfusion disappeared, Contrast agent perfusion did not fill at each phase contrast. a total of 14 lesions residue, contrast agent infusion reinforced quickly within or peripheral of lesions at arterial phase, portal phase and delayed phase faded, there were seven lesions surrounding a thick circular reinforcement in arterial phase, portal phase and delayed phase enhancement, considering edema.after Treatment 1 month later, conventional ultrasound、contrast-enhancd ultrasound and enhanced CT were done,conventional ultrasound showed 22 tumors were completely inactivated,9 lesions residue while contrast imaging showed 20 were completely inactivated, 11 lesions residue, enhanced CT showed 21 were completely inactivated,10 lesions residue, the final diagnosis standard of residual or the remaining depending on biopsy result, as a golden standard, conventional ultrasound diagnostic accuray was 60.8%((14/23),contrast-enhanced ultrasound diagnostic accuracy of 91.3%(21/23), and enhanced CT was 87.0%(20/23), there were statistical significance of differences in evaluating the effect of liver cancer after treatment between the sensitivity, specificity and accuracy. between CU and CEUS, while has no obvious statistical significance.between contrast-enhanced ultrasound and enhancement CTConclusion Using contrast-enhanced ultrasound can objectively and dynamically reflect the change of blood perfusion,before and after high intensity focused ultrasound treatment of liver cancer,then we can evaluate the effect of the treatment of large liver cancer accurately,It not only has the advantage of real-time, economy, safety, but also has similar role with enhanced CT.,.We can use CEUS as the preferred method to evaluate the curative effect of liver tumor... |
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