Evaluation of HIFU effect on hepatocellular carcinoma with dynamic contrast enhanced MRI

张园园; 赵建农; 郭大静; 吴伟; 陈维娟; 冉立峰

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Evaluation of HIFU effect on hepatocellular carcinoma with dynamic contrast enhanced MRI

更新时间：2026-01-09

- Evaluation of HIFU effect on hepatocellular carcinoma with dynamic contrast enhanced MRI
- Journal of Army Medical University Vol. 30, Issue 8, Pages: 754-757(2008)
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  CLC： R445.2;R454.3;R735.7
- Published：2008
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张园园,赵建农,郭大静,吴伟,陈维娟,冉立峰.MRI动态增强扫描评估HIFU治疗原发性肝癌的疗效[J].陆军军医大学学报(原第三军医大学学报),2008,30(08):754-757.

　ZHANG Yuan-yuan,ZHAO Jian-nong,GUO Da-jing,WU Wei,CHEN Wei-juan,RAN Li-feng.Evaluation of HIFU effect on hepatocellular carcinoma with dynamic contrast enhanced MRI[J].J Amry Med Univ (J Third Mil Med Univ),2008,30(08):754-757.
张园园,赵建农,郭大静,吴伟,陈维娟,冉立峰.MRI动态增强扫描评估HIFU治疗原发性肝癌的疗效[J].陆军军医大学学报(原第三军医大学学报),2008,30(08):754-757. DOI：

　ZHANG Yuan-yuan,ZHAO Jian-nong,GUO Da-jing,WU Wei,CHEN Wei-juan,RAN Li-feng.Evaluation of HIFU effect on hepatocellular carcinoma with dynamic contrast enhanced MRI[J].J Amry Med Univ (J Third Mil Med Univ),2008,30(08):754-757. DOI：

摘要

目的探讨MRI动态增强扫描在高强度聚焦超声(high intensity focused ultrasound， HIFU)治疗原发性肝癌疗效评价及预后判断中的价值。方法经临床或病理确诊的28例原发性肝癌患者共51个病灶，HIFU治疗前后行MRI动态增强扫描，分析HIFU治疗后病灶内部及其周边强化特点。结果 48个病灶行1次HIFU治疗，其中39个病灶(7647％)HIFU治疗1～2周后MRI复查病灶中央坏死、无强化，病灶周边呈环状强化，2～3个月、5～6个月、8～9个月、11～12个月、17～18个月以及20个月时上述病灶行1～6次MRI复查，未发现异常强化；4个病灶（7.84％）HIFU治疗1～2周后MRI复查病灶中央坏死、无强化，周边可见环状强化，2～3个月后MRI复查发现病灶边缘出现结节状强化；3个病灶(5.88％)HIFU治疗1～2周后MRI复查病灶内部和（或）周边仍可见点状、结节状或斑片状强化，2～3个月后MRI复查发现残存强化病灶范围扩大，数目增多；2个病灶(3.92％) 合并门静脉癌栓，经HIFU治疗后MRI复查有新病灶出现。3个病灶(5.88％)因体积太大(最大直径分别为9.6、12.7、14.8 cm)，采取分次HIFU治疗（2～3次），末次HIFU治疗后1～2周MRI复查并与治疗前对比发现，病灶呈大片状无强化低信号区。结论 MRI动态增强扫描可以敏感地反映HIFU治疗后病灶坏死情况及其周边强化特点。

Abstract

Objective To study the value of dynamic contrast-enhanced MRI in evaluating the curative effect of high intensity focused ultrasound (HIFU) for hepatocellular carcinoma (HCC) and the prognosis. Methods〖WTBZ〗Fifty-one lesions in twenty-eight patients with surgically or pathologically confirmed HCC underwent dynamic contrastenhanced MRI scanning before and after HIFU treatment. The enhancement features of the lesions and the surrounding tissues were analyzed. Results Forty-eight lesions underwent one HIFU treatment

among which 39 lesions (76.47％) showed no enhancement in the central necrotic regions or peripheral annular enhancement in 1-2 weeks after HIFU and no viable lesions were detected in the follow-up MRI; 4 lesions (7.84％) demonstrated no enhancement in the central necrotic regions

but peripheral annular enhancement in 1-2 weeks after HIFU and peripheral enhanced nodules in 2-3 months by the follow-up MRI; 3 lesions (5.88％) showed dot-like

nodal or patchy enhancement in the necrotic regions and (or) the surrounding tissues in 1-2 weeks after HIFU

and further

in the following 2-3 months

the enhanced survived lesions increased in size and number; 2 lesions (3.92％) complicated with portal vein thrombosis demonstrated new lesions after HIFU by the follow-up MRI. Due to their big size

3 lesions (5.88％) underwent more than one HIFU treatment (2-3 times). Lamellar necrosis without enhancement was shown in 1-2 weeks after the last HIFU treatment compared with prior HIFU treatment. Conclusion Dynamic contrast-enhanced MRI can sensitively reflect the enhancement features of necrosis and the surrounding tissues after HIFU.

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