动态三维超声造影对HBV相关肝细胞癌患者微波消融后临床疗效及复发的评估

摘要/Abstract

摘要： 目的探讨动态三维超声造影对HBV相关肝细胞癌患者微波消融后临床疗效及复发的评估效能。方法选取2018年11月至2023年1月鄂州市中医医院接受微波消融术治疗HBV相关肝细胞癌患者45例为研究对象,术后一个月分别使用二维超声造影和三维超声造影对疗效和复发情况进行评估,比较两种造影模式肿瘤显影结果以及疗效评估效能。结果 3D-CEUS检测肿瘤血管未显示、显示一般及显示清晰的例数分别为2例、5例和38例,与2D-CEUS[8例、12例和25例]比,差异具有统计学意义(χ²=9.165, P=0.010);3D-CEUS检测肿瘤边界未显示、显示一般及显示清晰的例数为4例、6例和35例,与2D-CEUS[5例、20例和20例]比,差异具有统计学意义(χ²=11.740, P=0.003)。术后活检结果提示45名患者中有11名患者治疗不充分或复发。比较疗效评估效能可知,3D-CEUS各项诊断效能指标均显著高于2D-CEUS,差异具有统计学意义(P<0.05)。结论动态三维超声造影有助于对HBV相关肝细胞癌患者微波消融后临床疗效及复发的评估。

关键词: 肝细胞癌, 射频消融, 三维超声造影

Abstract: Objective To explore the efficacy of dynamic three-dimensional contrast-enhanced ultrasonography (3D-CEU) in evaluating the clinical efficacy and recurrence of patients with hepatitis B-related hepatocellular carcinoma (HCC) after microwave ablation. Methods A total of 45 patients who received microwave ablation for hepatitis B-related HCC were selected between November 2018 and January 2023. Two-dimensional contrast-enhanced ultrasonography (2D-CEU) and 3D-CEU were used to evaluate the curative effect and recurrence at one month after the operation, and the two methods were compared on their imaging results of tumor in contrast mode and their efficacies on evaluating the curative effect. Results The numbers of cases in which 3D-CEUS detected tumor blood vessels was not displayed in 2 cases, normal in 5 cases, or clear in 38 cases, which were statistically significantly different with those of 8 cases, 12 cases and 25 cases, respectively, with 2D-CEUS (χ²=9.165, P=0.010). There were 4 cases, 6 cases and 35 cases in which 3D-CEUS showed no tumor boundary, normal tumor boundary and clear tumor boundary. Compared with those of 5 cases, 20 cases and 20 cases with 2D-CEUS, the difference was statistically significant (χ²=11.740, P=0.003). The results of postoperative biopsy showed that 11 of 45 patients had insufficient treatment or recurrence. Comparing their efficacy on evaluating the curative effect, the diagnostic efficacy indexes of 3D-CEUS are significantly higher than those of 2D-CEUS, and the difference is statistically significant (P<0.05). Conclusion Dynamic 3D-CEUS is helpful in evaluating the clinical efficacy and recurrence of patients with hepatitis B-related HCC after microwave ablation.

Key words: Hepatocellular carcinoma, Radiofrequency ablation, Three-dimensional contrast-enhanced ultrasound

尹雯, 沈荣. 动态三维超声造影对HBV相关肝细胞癌患者微波消融后临床疗效及复发的评估[J]. 肝脏, 2025, 30(9): 1249-1253.

YIN Wen, SHEN Rong. Using dynamic three-dimensional contrast-enhanced ultrasonography to evaluate the clinical efficacy and post-operative recurrence of microwave ablation for patients with hepatitis B-related hepatocellular carcinoma[J]. Chinese Hepatolgy, 2025, 30(9): 1249-1253.

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