Use of contrast-enhanced ultrasonography with a perflubutane-based contrast agent performed one day after transarterial chemoembolization for the early assessment of residual viable hepatocellular carcinoma

作者：Takizawa Kenichi; Numata Kazushi^*; Morimoto Manabu; Kondo Masaaki; Nozaki Akito; Moriya Satoshi; Ishii Tomohiro; Oshima Takashi; Fukuda Hiroyuki; Okada Masahiro; Takebayashi Shigeo; Maeda Shin; Tanaka Katsuaki

来源：European Journal of Radiology, 2013, 82(9): 1471-1480.

DOI：10.1016/j.ejrad.2013.04.045

• Contrast-enhanced ultrasonography
• Transarterial chemoembolization
• Hepatocellular carcinoma

Objective: We evaluated the efficacy of contrast-enhanced ultrasonography (US), compared with contrast-enhanced computed tomography (CT), for early assessments after transarterial chemoembolization (TACE) for the treatment of hypervascular hepatocellular carcinoma (HCC) lesions. %26lt;br%26gt;Subjects and methods: Thirty-two patients with 59 HCC lesions who were scheduled to receive TACE were enrolled in this prospective study. TACE was performed by injecting a mixture of iodized oil and miriplatin hydrate, followed by a gelatin sponge. Digital subtraction angiography (DSA) and/or contrast-enhanced CT were performed 2-6 months after TACE and were used as the reference standard for residual HCC; the detection rates for residual viable HCC using contrast-enhanced US with a perflubutane-based contrast agent and a high mechanical index (MI) mode performed one day after TACE were also compared with those obtained using contrast-enhanced CT performed one month after TACE. The comparisons were made using the McNemar test. %26lt;br%26gt;Results: Forty-seven (79.7%) of the 59 HCC lesions were diagnosed as having residual viability based on DSA and contrast-enhanced CT findings obtained 2-6 months after TACE. Eight (17.0%) of the 47 HCC lesions that were diagnosed as having residual viability using one-day contrast-enhanced US were not detected using one-month contrast-enhanced CT because of artifacts produced by the high attenuation of the iodized oil. The detection rate for residual HCC lesions using one-day contrast-enhanced US (95.7%, 45147) was significantly higher than that using one-month contrast-enhanced CT (78.7%, 37/47) (P%26lt;0.05). %26lt;br%26gt;Conclusion: Contrast-enhanced US performed one day after TACE is more sensitive than contrast-enhanced CT performed one month after TACE for detecting residual viable HCC.

• 出版日期2013-9