Evaluation of posttreatment response of hepatocellular carcinoma with contrast-enhanced coded phase-inversion harmonic US: Comparison with dynamic CT
Evaluation of posttreatment response of hepatocellular carcinoma with contrast-enhanced coded phase-inversion harmonic US: Comparison with dynamic CT
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DOI：
10.1148/radiol.2213010358
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发表时间：
2001-12-01
期刊：
影响因子：
19.7
通讯作者：
Maekawa, K
中科院分区：
文献类型：
--
作者：
Ding, H;Kudo, M;Maekawa, K
目得：为评价实时灰阶超声造影（US）评价肝细胞癌（HCC）治疗后疗效的可靠性，材料与方法：对50个HCC结节在治疗前后进行了对比增强编码相位反转谐波US检查。在早期动脉期用连续成像评估肿瘤内血管分布，在血池期用间隔延迟扫描描绘肿瘤实质血流。结果：治疗前50个HCC结节中，肿瘤血管阳性强化47个（94%），肿瘤实质血流阳性强化46个（92%）。在50个结节中，49个结节的肿瘤血管或染色用编码谐波US可视化。在49个治疗后HCC结节中进行了81项编码谐波US研究。与动态CT相比，编码谐波超声在帮助检测治疗前HCC阳性增强方面的敏感性、特异性和准确性分别为98%（49/50）、100%（50/50）和98%（49/50）。治疗后，在81项治疗后研究中，39项（48%）观察到肿瘤血管阳性增强，其他研究中未观察到增强（52%）。编码谐波超声分别在4个和1个结节中显示肿瘤血管部分增强和无增强;经导管动脉碘油栓塞后，由于油的存在，动态CT难以评价肿瘤血管。经过增强，编码谐波超声通过在连续成像时实时显示肿瘤血管和在间隔时间内显示肿瘤实质血流来描绘肿瘤血管分布。延迟扫描
PURPOSE: To assess the reliability of contrast material-enhanced real-time gray-scale ultrasonography (US) in evaluating posttreatment response of hepatocellular carcinoma (HCC).MATERIALS AND METHODS: Fifty HCC nodules were examined with contrast-enhanced coded phase-Inversion harmonic US before and after treatment. Intratumoral vascularity was assessed with continuous imaging in the early arterial phase and with interval-delay scanning to depict tumor parenchymal flow during the blood pool phase. Vascular findings at US were compared with those at dynamic computed tomography (CT).RESULTS: In 50 HCC nodules before treatment, positive enhancement of tumor vessels and tumor parenchymal flow (stain) were observed in 47 (94%) and 46 (92%), respectively. Either tumor vessel or stain was visualized with coded harmonic US in 49 of 50 nodules. Eighty-one coded harmonic US studies were performed in 49 posttreatment HCC nodules. Compared with dynamic CT, the sensitivity, specificity, and accuracy of coded harmonic US in helping to detect positive enhancement in pretreatment HCC were 98% (49 of 50), 100% (50 of 50), and 98% (49 of 50), respectively. After treatment, positive enhancement of tumor vascularity was observed in 39 (48%) of 81 posttreatment studies, and no enhancement was observed in others (52%). Coded harmonic US demonstrated partial and no enhancement of tumor vascularity in four and one nodule, respectively; after transcatheter arterial embolization with iodized oil, evaluation of tumor vascularity with dynamic CT was difficult because of the presence of oil.CONCLUSION: With enhancement, coded harmonic US depicted tumor vascularity by showing tumor vessels in a real-time fashion at continuous imaging and tumor parenchymal flow at interval-delay scanning.