| 摘要: |
| 目的 对比Sonazoid与SonoVue两种超声造影剂在超声引导下小肝癌微波消融术中的应用价值。方法 回顾性分析浙江大学医学院附属杭州市西溪医院2021年1月至2022年12月超声引导下经皮微波消融治疗小肝癌患者的临床资料。按术中使用造影剂的不同分为Sonazoid组和SonoVue组，两组病例均行超声造影使肿瘤显影清晰后再穿刺布针。制订穿刺布针过程5分难度表，对比两组病例穿刺布针难度。消融后3个月内行增强影像（增强MRI、增强CT或超声造影）检查以评估近期疗效。结果 最终纳入67例患者：Sonazoid组患者25例，年龄41-82（60.64±9.46）岁，肿瘤大小1.1-2.8（1.78±0.45）cm；SonoVue组患者42例，年龄38-78（62.26±9.27）岁，肿瘤大小1.1-3.0（1.89±0.49）cm。两组患者年龄、肿瘤大小差异均无统计学意义（P均＞0.05）。穿刺布针难度评分：Sonazoid组2.0-2.7（2.28±0.29）分，SonoVue组2.0-4.7（2.95±0.85）分，两组评分差异有统计学意义（P＜0.05）。消融后3个月内增强影像检查结果：Sonazoid组完全消融率100%（25/25），SonoVue组完全消融率95.2%（40/42），两组差异无统计学意义（P＞0.05）。结论 超声造影有利于灰阶超声显影不清晰的小肝癌在消融前的穿刺布针，在Sonazoid造影的后血管相，肿瘤可以长时间清晰显影，使得术者能够进行连续操作、精准布针，降低了穿刺布针的难度，从而有可能取得更好的消融效果。 |
| 关键词: 癌 肝细胞 消融技术 超声检查 |
| DOI： |
| 投稿时间：2023-04-13修订日期：2023-06-11 |
| 基金项目:浙江省医药卫生科技计划项目(2021KY937) |
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| Comparison of two different contrast media in ultrasound guided microwave ablation of small hepatocellular carcinoma |
| Delin Liu,Zixiang Kong,Fei Liang,Yi Guo,Xia Hong |
| (Department of Ultrasound,Hangzhou Xixi Hospital,Affiliated to Zhejiang University Medical College.Hangzhou 310023;China) |
| Abstract: |
| Objective Comparison of the value of Sonazoid and SonoVue in ultrasound guided microwave ablation of small hepatocellular carcinoma. Methods The clinical data of patients with small hepatocellular carcinoma treated by ultrasound guided percutaneous microwave ablation from January 2021 to December 2022 in Hangzhou Xixi Hospital affiliated to Zhejiang University School of Medicine were retrospectively analyzed. The patients were divided into Sonazoid group and SonoVue group according to the different contrast media used during the operation. Both groups of patients underwent CEUS to make the tumor clear before puncture. Make a 5-point difficulty table for the puncture process and compare the puncture difficulty of the two groups of cases. Contrast-enhanced imaging（CEMRI、CECT or CEUS） was performed within 3 months after ablation to evaluate the short-term efficacy. Results Finally,67 patients were included in the study. Of the 25 patients in the Sonazoid group, the age ranged from 41 to 82 (60.64 ± 9.46) years, and the tumor size ranged from 1.1 to 2.8 (1.78 ± 0.45) cm. Of the 42 patients in the SonoVue group, the age ranged from 38 to 78 (62.26 ± 9.27) years, and the tumor size ranged from 1.1 to 3.0 (1.89 ± 0.49) cm. There was no significant difference in age and tumor size between the two groups (P>0.05). The score of puncture difficulty was ranged from 2.0 to 2.7 (2.28 ± 0.29) points in Sonazoid group and ranged from 2.0 to 4.7 (2.95 ± 0.85) points in SonoVue group. The difference between the two groups was significant (P<0.05). The results of Contrast-enhanced imaging examination within 3 months after ablation showed that the complete ablation rate in Sonazoid group was 100% (25/25), and in SonoVue group was 95.2% (40/42). There was no statistically significant difference between the two groups (P>0.05). Conclusion CEUS is beneficial for puncture before ablation of small hepatocellular carcinoma that is not clearly visualized on gray-scale ultrasound. In the post-vascular phase of Sonazoid, tumors can be clearly visualized for a long time. This allows surgeons to continuously operate and accurately puncture, and reduces the difficulty of puncture. It is possible to achieve better ablation effects. |
| Key words: Carcinoma Hepatocellular Ablation techniques Ultrasonography |
