中文摘要：

目的：探讨对比增强超声（CEUS）在肝脏残留复发性恶性肿瘤进行射频消融（RFA）治疗的临床应用。方法517例原发性肝癌（HCC）、肝转移癌患者经各种治疗后残留或局部复发拟行RFA治疗，共619个病灶为研究对象。复发HCC 281例290灶，病灶大小平均（3.4±1.5）cm，其中CEUS引导治疗组150例154灶，常规超声引导组131例136灶。另复发肝转移癌236例329灶，病灶大小平均（3.1±1.3）cm，其中CEUS引导治疗组152例198灶，常规超声引导组84例131灶。结果复发HCC CEUS组与常规组治疗结果比较：1个月肿瘤灭活率分别为96.1%和89.7%（P =0.032）；肿瘤局部复发率各为9.7%和17.6%（P=0.049）；两组间差异均有统计学意义。复发肝转移癌CEUS组与常规组治疗结果比较：1个月肿瘤灭活率88.4%和87.0%（P=0.712）；肿瘤局部复发率16.7%和23.7%（P=0.117），两组间差异均无统计学意义。结论 CEUS 指导RFA治疗复发HCC，可有效提高早期灭活率，降低局部复发。

英文摘要：

Objective To discuss the clinical application of contrast enhanced ultrasonography （CEUS） in radiofrequency ablation （RFA） treatment for residual and recurrent hepatic neoplasms. Methods A total of 517 cases of primary hepatocellular carcinoma （HCC） or hepatic metastases with residual or recurrent hepatic neoplasms after different kinds of treatment were treated with RFA. A total of 619 lesions were used as study subjects. The average size of the 290 lesions detected in 281 patients with recurrent HCC was （3.4 ± 1.5） cm. CEUS-guided RFA group included 150 cases （154 lesions in total）, while conventional US-guided RFA group included 131 cases （136 lesions in total）. A total of 329 lesions were detected in 236 cases with recurrent hepatic metastases, and the mean size of the lesions was （3.1 ± 1.3） cm, of which CEUS-guided RFA group included 152 cases （198 lesions in total） and conventional US-guided RFA group included 84 cases （131 lesions in total）. Results In recurrent HCC, the one-month tumor necrosis rate of CEUS group and conventional US group was 96.1% and 89.7% respectively （P = 0.032）, and the local recurrence rate was 9.7% and 17.6% respectively （P = 0.049）. The differences between the two groups were statistically significant. In recurrent hepatic metastases , the one-month tumor necrosis rate of CEUS group and conventional US group was 88.4% and 87.0% respectively （P = 0.712）, and the local recurrence rate was 16.7% and 23.7%respectively （P = 0.117）. No significant differences existed between the two groups. Conclusion For the treatment of recurrent HCC, CEUS-guided radiofrequency ablation can effectively improve the early necrosis rate and decrease local recurrence rate.