超声在肝细胞癌消融疗效评估中的应用与进展

李清心; 李杰; 张德智

doi:10.12449/JCH260706

超声在肝细胞癌消融疗效评估中的应用与进展

DOI: 10.12449/JCH260706

吉林大学第一医院超声诊断中心腹部超声科，长春 130021

利益冲突声明：本文不存在任何利益冲突。

作者贡献声明：李清心负责撰写文章初稿；李杰负责整理参考文献，协助完善文章内容；张德智负责指导文章思路架构并审定终稿。

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通信作者:
张德智， dezhi@jlu.edu.cn （ORCID： 0000-0002-4331-008X）

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出版历程
- 收稿日期: 2026-07-15
- 录用日期: 2026-07-31
- 出版日期: 2026-07-25

Application and progress of ultrasound in treatment response assessment after ablation for hepatocellular carcinoma

Department of Abdominal Ultrasound，Diagnostic Ultrasound Center，The First Hospital of Jilin University，Changchun 130021，China

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Corresponding author: Zhang Dezhi， dezhi@jlu.edu.cn （ORCID： 0000-0002-4331-008X）

摘要

摘要: 肝细胞癌（HCC）局部消融治疗后的准确疗效评价对于识别残余活性肿瘤、判断消融边界及指导后续随访与监测具有重要意义。增强计算机体层成像和磁共振成像是目前主要评价手段，但在实时动态观察、术中应用及重复性方面存在一定局限性。超声，尤其是超声造影（CEUS）凭借实时显示微循环灌注、无电离辐射和可重复等优势，可贯穿HCC消融治疗全过程，在残余肿瘤识别、即时疗效判断及随访管理中发挥重要作用。本文围绕HCC热消融疗效评价的病理学基础、主要评价终点、超声技术及CEUS肝脏影像报告与数据系统治疗反应评估算法的应用进展进行综述，并探讨多模态融合、定量分析及标准化评价的发展方向，为进一步优化HCC消融疗效评估体系提供参考。
- 癌，肝细胞 /
- 消融技术 /
- 超声疗法
Abstract: Accurate assessment of treatment response after local ablation is of great importance for detecting residual viable tumor， evaluating ablative margins， and guiding subsequent follow-up and monitoring in patients with hepatocellular carcinoma （HCC）. Contrast-enhanced computed tomography and magnetic resonance imaging are currently the main imaging modalities for post-ablation evaluation， but have certain limitations in real-time imaging， intraoperative application， and repeatability. Ultrasound， especially contrast-enhanced ultrasound （CEUS）， can be used throughout the entire process of ablation therapy for HCC due to its advantages of real-time visualization of microvascular perfusion， no ionizing radiation， and repeatability， thereby playing an important role in detecting residual viable tumor， assessing immediate treatment response， and monitoring patients during follow-up. This article reviews the pathological basis and major endpoints of treatment response assessment after thermal ablation for HCC， with a focus on the clinical application of ultrasound techniques and the Contrast-Enhanced Ultrasound Liver Imaging Reporting and Data System Treatment Response Algorithm. In addition， it discusses the future development directions of multimodal imaging， quantitative assessment， and standardized evaluation， in order to provide a reference for further optimizing the treatment response assessment system for HCC after ablation.
- Carcinoma， Hepatocellular /
- Ablation Techniques /
- Ultrasonic Therapy

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注： LI-RADS，肝脏影像报告与数据系统；CEUS，超声造影；LR-TR，肝脏影像报告与数据系统治疗反应评估。

图 1 2024年版LI-RADS CEUS非放射治疗反应评估流程图

Figure 1. Flowchart of CEUS LI-RADS TRA （non-radiation treatment response assessment）， 2024 edition

下载: 全尺寸图片幻灯片

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