2018 年第 11 期 第 13 卷

实时三维超声造影对索拉非尼治疗原发性肝癌效果的评估价值

Value of real-time three-dimensional contrast-enhanced ultrasonography in evaluation of primary hepatocellular carcinoma treated with sorafenib

作者：王蓓徐秀梅牟洋翟虹

英文作者：

单位：830000乌鲁木齐，新疆医科大学附属中医医院腹部超声科

英文单位：

关键词：原发性肝癌；实时三维超声造影；索拉非尼

英文关键词：

• 摘要：

• 【摘要】目的    探讨实时三维超声造影（3D-CEUS）对索拉非尼治疗原发性肝癌效果的评估价值。方法    选取2016年7月至2018年2月于新疆医科大学附属中医医院住院经临床确诊的中晚期原发性肝癌患者60例，均给予口服索拉非尼400 mg、2次/d靶向治疗，治疗前和治疗3个月后对肝脏目标病灶进行3D-CEUS检查，比较其与二维超声造影（2D-CEUS）两种检查方法的肿瘤三维立体形态及肿瘤血管空间构建显示率、肿瘤滋养血管显示情况和残留病灶治疗前及治疗3个月后增强时间、增强强度与曲线下面积。结果    3D-CEUS肿瘤三维立体形态及肿瘤血管空间构建的显示率为91.7%(55/60)。3D-CEUS下肿瘤滋养血管显示1条33例、2条12例、3条8例，4条及以上7例，2D-CEUS肿瘤滋养血管显示1条6例、2条4例、未显示50例，3D-CEUS肿瘤滋养血管显示情况优于2D-CEUS（P＜0.05）。60例患者治疗后增强时间长于治疗前［(16±5)s比（12±3）s］，且治疗后增强强度以及曲线下面积均小于治疗前（均P＜0.05）。结论    实时3D-CEUS对索拉非尼治疗原发性肝癌效果的评估价值较高。

• 【Abstract】Objective    To explore the value of real-time three-dimensional contrast-enhanced ultrasonography（3D-CEUS） in evaluation of primary hepatocellular carcinoma treated with sorafenib. Methods    From July 2016 to February 2018, 60 patients with advanced primary liver cancer hospitalized in Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University were enrolled. They were treated with solafenib 400 mg twice a day orally. 3D-CEUS and two-dimensional contrast-enhanced ultrasonography（2D-CEUS） were performed before and 3 months after treatment; the shape of tumor, the spatial construction of tumor vessels, the display of tumor vasculature, and ultrasonic parameters of residual tumor［enhancement time, intensity and area under the curve］ were analyzed. Results    The display rates of 3D tumor shape and the spatial construction of tumor vessels in 3D-CEUS were significantly higher than those in 2D-CEUS(P<0.05). 3D-CEUS showed one nourishing vessel in 33 cases, two nourishing vessels in 12 cases, three nourishing vessels in 8 cases, and more than four nourishing vessels in 7 cases. 2D-CEUS only showed one nourishing vessel in 6 cases and two vessels in 4 cases; 50 cases were not displayed. The display of tumor vasculature of nourishing vessels in 3D-CEUS was better than that in 2D-CEUS（P＜0.05）. After 3 months of treatment, the enhancement time of residual tumor was significantly longer than that before treatment［(16±5)s vs （12±3）s］; the enhancement intensity and area under the curve were significantly less than those before treatment［(19±4)dB vs （24±5）dB, (599±56) vs （1 040±77）］(P<0.05). Conclusion    3D-CEUS has a good evaluation value for the treatment of primary hepatocellular carcinoma with sorafenib.