Advanced dynamic flow Imaging with contrast-enhanced ultrasonography for the evaluation of tumor vascularity in liver tumors
Advanced dynamic flow Imaging with contrast-enhanced ultrasonography for the evaluation of tumor vascularity in liver tumors
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DOI：
10.1016/j.clinimag.2004.03.001
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发表时间：
2005-01-01
期刊：
影响因子：
2.1
通讯作者：
Kakumu, S
中科院分区：
文献类型：
--
作者：
Hotta, N;Tagaya, T;Kakumu, S
为了研究先进的动态血流成像在诊断肝肿瘤和评估肝细胞癌（HCC）和转移性肝肿瘤患者的治疗效果中的作用，我们使用微泡造影剂Levovist进行了超声造影（US）。本文对35个肝癌结节中22例丙型肝炎病毒（HCV）感染和6例转移性肝结节进行了研究。经螺旋动态CT和/或腹腔血管造影诊断为HCC或转移瘤。在早期动脉和血管后阶段的肿瘤血管进行了评估，通过实时扫描的先进动态血流成像和间歇性间隔延迟扫描的对比脉冲减影成像与宽带能量多普勒技术。所有患者在对比增强US和/或动态CT上均显示HCC的富血管增强。可以获得肝脏肿瘤的血管和灌注图像的高级动态血流。在射频消融（RFA）治疗前，29个结节中的27个结节（包括17例27个HCC结节和2例2个转移性结节）的肿瘤血管（包括肿瘤血管和实质血流）能够通过对比增强谐波超声的高级动态血流显示。两个结节的动态血流不足，位于距体表约12 cm处。RFA后7 - 10天进行的高级动态血流显示，27个可见结节中有27个肿瘤血管消失。螺旋动态CT早期检查结果与动态血流超声血管期检查结果一致。没有观察到RFA手术的重大并发症。结果表明，超声造影剂增强的先进动态血流成像能真实的实时地显示肿瘤内的血管，对肝癌和转移性肝肿瘤的诊断和疗效评估有重要价值。(C)2005年爱思唯尔公司All rights reserved.
To examine the usefulness of advanced dynamic flow imaging in diagnosing hepatic tumor and in assessing therapeutic effects in patients with hepatocellular carcinoma (HCC) and metastatic hepatic tumor, we performed contrast-enhanced ultrasonography (US) with Levovist, a microbubble contrast agent. Twenty-two patients of 35 HCC nodules infected with hepatitis C virus (HCV) and six patients with metastatic liver nodules were studied. They were diagnosed as having HCC or metastasis with helical dynamic computed tomography (CT) and/or celiac angiography. Tumor vascularities in the early arterial and postvascular phases were assessed by real-time scanning of advanced dynamic flow imaging and intermittent interval-delay scanning of contrast pulse subtraction imaging with a wide-band power Doppler technology. All patients showed hypervascular enhancement of HCC on contrast-enhanced US and/or dynamic CT. The advanced dynamic flow could be obtained as vascular and perfusion images of hepatic tumors. Tumor vascularities, including tumor vessels and parenchymal flow, were able to demonstrate in 27 of 29 nodules including 17 patients with 27 HCC nodules and 2 patients with 2 metastatic nodules before radiofrequency ablation (RFA) treatment by the advanced dynamic flow on contrast-enhanced harmonic US. Two nodules gave insufficient dynamic flow which were located approximately 12 cm in depth from the body surface. The advanced dynamic flow, which was done 7 - 10 days after RFA, indicated disappearance of the tumor vessels in 27 of visible 27 nodules. The study on early phase of helical dynamic CT revealed the same results as noted in early vascular phase of dynamic flow US. No major complication of RFA procedure was noted. The results indicated that contrast-enhanced advanced dynamic flow imaging on US clearly depicted intratumoral vascularity in real time and thus it is useful to diagnose and assess therapeutic efficacy in patients with HCC and metastatic liver tumor. (C) 2005 Elsevier Inc. All rights reserved.