Abstract: Objective The aim of this study was to observe the efficacy of microwave ablation (MWA) under the guidance of real-time contrast-enhanced ultrasound(CEU) and fusion image navigation (FIN) in treatment of patients with small primary liver cancer (PLC).Methods 142 patients with small PLC were admitted to our hospital between December 2013 and December 2016, and were randomly divided into two groups, with 71 cases in each group. The patients in observation group received MWA under the real-time CEU and FIN guidance, and those in the control group received surgical resection. Serum alpha-fetoprotein (AFP),α-L-fucosidase (AFU) and carbohydrate antigen 19-9 (CA19-9)levels were assayed. Results At the end of three months after treatment, the complete ablation rate in the observation group was 93.8%, and the complete removal in the control was 100.0%(P>0.05); there were no significant differences as compared to serum AFP, AFU and CA19-9 levels in the two groups(P＞0.05); the complication occurrence, such as pulmonary infection, bile leak, incision infection,peritoneal or pleural effusion in the observation group was4.2%, significantly lower than 25.3%(P＜0.05) in the control; the patients were followed-up for 3 to 36 months withmedium of 18 months, and the survival rate in the observation was 73.2%(52/71), not significantly different compared to 71.8%(51/71) in the control (Log-rank=0.086,P=0.763).Conclusion The application of MWA under the guidance of real-time CEU and FIN in the treatment of patients with small PLC is efficacious, similar to surgical resection, which is worthy of clinicalverification.

Key words: Hepatoma, Small liver cancer, Real time contrast-enhanced ultrasound, Fusion image navigation, Microwave ablation, Surgery