实时灰阶超声造影在肝肿瘤诊断中的价值

Role of contrast-enhanced ultrasound in assessing short-term therapeutic response to high-intensity focused ultrasound in patients with pancreatic carcinoma

AIM: To evaluate the role of contrast-enhanced ultrasound (CEUS) in assessing the short-term therapeutic response to high-intensity focused ultrasound (HIFU) in patients with pancreatic carcinoma.

METHODS: Twenty-nine patients with pancreatic carcinoma received HIFU treatment. CEUS was performed to monitor the response of tumor vessels to HIFU ablation before and after treatment. Meanwhile, 15 patients underwent magnetic resonance imaging (MRI) for comparison.

RESULTS: Before treatment, hypoenhancement was found on CEUS in 23 (79.3%) patients, and isoenhancement to hyperenhancement in 6 (20.7%) patients. Contrast agent washout was significantly faster in pancreatic carcinoma lesions than in normal pancreatic tissue in all cases. Complete non-enhancement area was noted in 8 cases after first HIFU therapy, in 12 cases after second therapy, and in 4 cases after third treatment. Five cases presented hypoenhancement at the boundary of the lesion even after third treatment and needed more treatments. The accuracy of CEUS was similar to that of MRI in assessing the response to HIFU therapy (86.7% vs 93.3 %, P > 0.05).

CONCLUSION: CEUS allows to accurately differentiate tumor necrosis and evaluate response to HIFU treatment in patients with pancreatic carcinoma.

Contrast-enhanced ultrasound in assessment of the therapeutic efficacy of high intensity focused ultrasound in treating hepatocellular carcinoma

AIM: To evaluate the role of contrast-enhanced ultrasonography in assessing the short-term therapeutic response of hepatocellular carcinoma with high intensity focused ultrasound (HIFU).

METHODS: Thirty two patients with hepatocellular carcinoma (HCC) received HIFU treatments including 23 part-covered treatments and 9 full-covered treatments. Contrast-enhanced ultrasound (CEUS) imaging was performed to monitor the response of tumor vessels to HIFU ablation before the treatment and 1-4 d after the treatment separately. Simultaneously, all patients underwent routine US for comparison.

RESULTS: Compared with tumor images in the patients before HIFU which showed multiple blood flow signals, clinical images showed an abrupt interruption, followed by the cessation of blood flow within the tumor vessels after HIFU treatment, demonstrating that homogeneous coagulative necrosis occurred in the treatment area. According to the final diagnosis as gold standard, the accuracy of CEUS for HIFU was much better than the conventional ultrasonography (90.6% vs 46.9%, P < 0.05).

CONCLUSION: CEUS can accurately differentiate tumor necrosis and evaluate therapeutic efficacy of HIFU.