Application of contrast-enhanced ultrasound combined with imaging navigation in diagnosis and minimally invasive treatment of small liver cancer

MAO Feng; DONG Yi; WANG Yiping; FAN Peili; CAO Jiaying; WANG Wenping

doi:10.19732/j.cnki.2096-6210.2019.02.004

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Application of contrast-enhanced ultrasound combined with imaging navigation in diagnosis and minimally invasive treatment of small liver cancer

更新时间：2025-12-15

- Application of contrast-enhanced ultrasound combined with imaging navigation in diagnosis and minimally invasive treatment of small liver cancer
- Vol. 28, Issue 2, Pages: 84-89(2019)
- 作者机构：
  
  1. 复旦大学附属中山医院超声科,上海,200032
  2. 上海市影像医学研究所,上海,200032
- 作者简介：
- 基金信息：
- DOI：10.19732/j.cnki.2096-6210.2019.02.004
  CLC：
- Published Online：24 May 2019，
  
  Published：24 May 2019
- 稿件说明：
移动端阅览
毛枫,董怡,王依平,等. 超声造影联合影像导航在小肝癌微创诊治中的应用研究[J]. 肿瘤影像学, 2019, 28(2): 84-89 https://doi.

org/10.19732/j.cnki.2096-6210.2019.02.004
毛枫,董怡,王依平,等. 超声造影联合影像导航在小肝癌微创诊治中的应用研究[J]. 肿瘤影像学, 2019, 28(2): 84-89 https://doi. DOI： 10.19732/j.cnki.2096-6210.2019.02.004.

org/10.19732/j.cnki.2096-6210.2019.02.004 DOI：

摘要

目的：

探讨超声造影（contrast-enhanced ultrasound，CEUS）联合影像导航技术在小肝癌诊治中的应用价值。

方法：

选取2017年9月2018年12月于复旦大学附属中山医院就诊的小肝癌患者24例，CEUS检查前增强磁共振成像（magnetic resonance imaging，MRI）显示肝内有增强病灶，但常规超声对可疑病灶显示不清，故采用MRI导航下的CEUS，分析其对病灶的显示率及增强表现，并进行定性诊断、微创治疗前定位及治疗后的随访。

结果：

24例患者共26个病灶纳入研究，均完成MRI-CEUS图像融合导航，融合成功率100%。26个病灶均小于20 mm，常规超声显示等回声8个、稍低或低回声10个、稍高回声或高回声8个。单独采用CEUS发现18个病灶（18/26，69.2%），CEUS联合MRI导航检出26个病灶（26/26，100%），两者间差异有统计学意义（

=0.004）。在实时MRI导航CEUS中，16个病灶（61.5%，16/26）动脉期表现为快速增强，10个表现为同步增强；门静脉期18个病灶（69.2%，18/26）呈等回声，8个（30.8%，8/26）呈低回声；延迟期10个病灶（38.5%，10/26）仍表现为等回声，余16个病灶呈低回声。检查完成后，4例患者行外科手术切除，10例行射频消融或乙醇注射治疗，4例行介入治疗，6例随访半年后行射频治疗。术后随访中，增强MRI显示所有病灶均完全坏死。

结论：

CEUS联合影像导航技术能显著提高小肝癌的检出率，指导选择治疗方案，值得在临床上推广应用。

Abstract

Objective:

To explore the application of contrast-enhanced ultrasound (CEUS) combined with imaging navigation in the diagnosis and treatment of small liver cancer.

Methods:

Twenty-four patients with small liver cancer admitted to Zhongshan Hospital

Fudan U

niversity from Sep. 2017 to Dec. 2018 were involved in the study. Contrast-enhanced magnetic resonance imaging (MRI) showed intrahepatic enhanced lesions

which were not clearly displayed on conventional ultrasound

and then ultrasound navigation was performed. The enhancement appearance and detection rate of the lesions by CEUS combined with imaging navigation were analyzed. All the lesions were diagnosed definitely

localized before minimally invasive treatment and followed up after treatment.

Results:

Twenty-six lesions of 24 patients were included in the study. All the patients underwent MRI-CEUS image fusion navigation

and the success rate of fusion was 100%. The size of all the 26 lesions was less than 20 mm. Eight lesions were isoechoic

10 lesions were hypoechoic and the other 10 lesions were hyperechoic on conventional ultrasound. Eighteen lesions (18/26

69.2%) were detected by CEUS alone

whereas all the 26 lesions (26/26

100%) were detected by MRI-CEUS image fusion navigation. And there existed statistically significant difference (

=0.004) between them. In real-time MRI-CEUS navigation

16 lesions (61.5%

16/26) showed rapid enhancement in the arterial phase

and 10 showed synchronous enhancement. In the portal phase

18lesions (69.2%

18/26) were isoechoic and 8 were hypoechoic. In the delayed phase

10 lesions (38.5%

10/26) were isoechoic and the other 16 lesions (61.5%

16/26) were hypoechoic. After the examinations

4 patients underwent surgical resection

10 underwent radiofrequency ablation or alcohol injection treatment

and 4 underwent interventional treatment. The other 6 patients underwent radiofrequency ablation treatment after follow-up for half a year. All the lesions showed complete necrosis on enhanced MRI during follow-up.

Conclusion:

CEUS combined with imaging navigation can significantly improve the detection rate of small liver cancer and guide the choice of treatment options. It is worthy of clinical application.

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