编码谐波造影在超声导向微波凝固治疗肝肿瘤前的应用

目的：评价微波凝固治疗肝脏肿瘤前行编码谐波造影（CHA）检查的应用价值。方法：35例临床诊断肝肿瘤患者，经声诺维编码谐波造影检查，观察肿块大小、数目、形态及边界，与彩色多普勒超声、病理检查进行比较。结果：共查出55个病灶，彩色多普勒超声、CHA对肝肿瘤病灶的检出率分别为85．4％、96．4％；最大径小于1．0cm的肿块，彩色多普勒超声、CHA对肝肿瘤病灶的检出率分别为是41．7％、83．3％。彩色多普勒超声有60％（33／55）的病灶边界显示不清晰，CHA有7．3％（4／55）的病灶边界显示不清。彩色多普勒超声对肝恶性肿瘤诊断的灵敏度、特异度、准确度分别是64．8％、50％、61．7％；CHA对肝恶性肿瘤诊断的灵敏度、特异度、准确度分别是97．7％、90％、96．2％，两者之间差异有统计学意义（P〈0．05）。结论：超声导向微波热凝固肝肿瘤前行编码谐波造影，在判断肿块数目、大小、边界较彩色多普勒超声提供的信息多；CHA对肝肿块性质鉴别优于彩色多普勒超声，对治疗方案的确立有重要的作用。

The value of coded harmonic angio before liver tumors treated by microwave tissue coagulation with ultrasound guided

Objective ：To evaluate the role of coded harmonic angio （CHA）in the detection of liver tumors before microwave tissue coagulation . Methods： Thirty five patients with liver tumors diagnosed clinically were enrolled in the study, the number , size, and edge of the masses were observed after injecting SonoVue via vein. The results were compared with color Doppler ultrasonography and pathology. Results： Fifty five masses were discovered in all cases, The recall ratios of color Doppler ultrasonography and CHA were 85.4% and 96.4% respectively. For the tumors that maximum diameter was under 1.0 cm, the recall ratio of color Doppler ultrasonography and CHA were 41.7% and 83.3% respectively. 60% （33/55） tumors＇edge was shown unclearly when observed through color Doppler ultrasonography, while for the CHA, only 7.3% （4/55）tumors＇ edge was not shown clearly. The sensitivity, specificity and accuracy of color Doppler ultrasonography in diagnosing malignant tumor of liver was 64.8%, 50% and 61.7%. As for CHA, they were 97.7% ,90% and 96.2%. The difference was statistically significant （P 〈 0.05 ）. Conclusion： Before liver tumors treated by microwave tissue coagulation with nltrasonography guided, CHA may provide more information of number,size and edge of the tumors than color Doppler nltrasonography. It is superior to color Doppler ultrasonography in identifying tumors, CHA play an important role in choosing non - operative indication and establishing the treatment protocol.