The Study Of Application Of Immediate Contrast-Enhanced Ultrasound In Primaryi Hepatic Carcinoma By High Intensity Focusedultrasound Therapy

Objectives:To explore the value of clinical application of immediate contrast-enhanced ultrasound in primary hepatic carcinoma by high intensity focused ultrasound (HIFU) therapy and observe the therapeutic effects.Methods:Fifty-five cases(68 lesions) of hepatocellular carcinoma(HCC) were randomized into 2 groups,30 cases (38 lesions) were A group,25 cases(30 lesions) were B group. Patients of A group were examined by contrast-enhanced ultrasound (CEU)with low mechanical index (Ml)before and after therapy in 10 minutes.We observed the perfusion of ultrasound contrast agent (UCA)real time. Patients were all taken 2D and CDU.The number and size of the lesions were recorded .Blood sign in the tumor was observed.The lesions of incomplete deactivation were treated by HIFU in time. Patients of B group had not made contrast-enhanced ultrasound and supplement therapy. We observed the treatment security and judged the therapeutic effects by the clinical symptom, serum AFP and imaging appearance.The long-term therapeutic effects were judged by follow-up survival rate.Results:32 lesions of patients in group A were examined by 2D and CDU, and 38 lesions were examined by CEU. 19 lesions which showed hyper-enhancement after immediate contrast-enhanced ultrasound were diagnosed as tumor residual. The signal of bleeding was not detected in the lesions by the examination of CDFI. We run supplementary treatment to 19 lesions by HIFU in time.No serious complication was identified.The AFP descending rate in group A and group B was 86.7% (26/30), 64.0% (16/25) respectively.The lesions complete necrosis rate in group A and group B was 97.3% (37/38),60.0% (18/30) respectively. Half year, 1 year survival rate in group A and group B was 100%, 90.0% and 76.0%, 68.0% respectively. The differences were significant( P <0.05).Conclusion:1 .CEU is outweighed 2D and CDU in the detection of number, size and blood sign.2.Immediate contrast-enhanced ultrasound may immediately evaluate and timely instruct supplementary treatment in primary hepatic carcinoma by HIFU therapy. It can help to destroy the lesions completely.3.HIFU supplementary treatment instructed by immediate contrast-enhanced ultrasound may provide a new method and a new thinking for primary hepatic carcinoma by HIFU therapy. The symptom of patients after the treatments was alleviated, the life quality was improved, the life-time was prolonged .It has the better clinical practice value.