摘要
目的探讨高强度聚焦超声(HIFU)治疗门静脉癌栓的有效性及临床应用价值。方法对26例晚期肝癌合并门静脉癌栓患者的33支门静脉主干或(和)第1级分支内癌栓进行HIFU治疗,观察治疗后癌栓支门静脉血流变化、癌栓回声和消减变化以及患者肝功能、腹水和生活质量改善情况。结果治疗前6例8支门静脉充满型癌栓支彩色多普勒超声无血流信号,癌栓呈低回声或等回声;治疗2-3次后,7支门静脉癌栓由低回声或等回声变为中等回声或强回声,癌栓体积较治疗前缩小1/2-1/3,门静脉内见到彩色血流信号;第5次治疗后,8支门静脉癌栓支均见彩色血流信号,癌栓体积进一步缩小,其中6支见到连续稳定的再通血流信号,患者肝功能、腹水和生活质量均有不同程度的改善。20例25支非充满型门静脉癌栓经3-5次治疗后,癌栓回声明显增强,其体积缩小 1/2-1/5,原来连续不稳定的血流信号变为连续稳定的再通血流信号。结论 HIFU治疗门静脉癌栓安全、痛苦小、无创伤、有肯定的疗效,有望成为一种用于治疗大多数门静脉癌栓的新方法。
Objective To evaluate the efficacy, safety and clinical value of high intensity focused ultrasound （HIFU） for the treatment of portal vein tumor thrombus （PVTY） in patients with liver cancer. Methods A total of 26 patients with advanced liver carcinoma （ including 33 PVTY portal veins and their main branches） were treated with HIFU. The changes in the blood flow of PWIT embolized portal veins, echo and size of tumor thrombi, liver function, ascites and the life quality were observed. Results Before treatment there was no blood flow signal with low echo and equivalent echo on color Doppler ultrasonography in 8 PWIT embolized portal veins. After 2 or 3 treatments, the low or equivalent echo became moderate or strong echo; the volumes of tumor thrombi were reduced by 1/3 to 1/2; and color flow signals were seen in 7 portal veins. After 3 or 5 treatments, the echo of tumor thrombi was significantly enhanced; and the volumes of tumor thrombi were reduced 1/5 to 1/2; and the flow signals became continuous and stable, indicating re-patency. The improvements of liver function, ascites and the life quality in varying degrees were observed. Conclusions HIFU treatment may be an effective, safe, less painful and non-invasive procedure in the control of PVTY in liver cancer patients.
出处
《中华医学超声杂志（电子版）》
2005年第3期162-165,共4页
Chinese Journal of Medical Ultrasound(Electronic Edition)
