Abstract: Objective The aim of this study was to investigate the guidance of real-time contrast-enhanced ultrasonography and 3D ultrasound fusion imaging for ablation area in patients with primary liver cancer(PLC)during microwave ablation (MWA) therapy. Methods A total of 102 patients with PLC were encountered in Meizhou People's Hospital between February 2017 and February 2021, and were randomly divided into observation (n=51) and control group (n=51). They were all treated with MVA. In the control group, the conventional contrast-enhanced ultrasonography was applied to evaluate the ablation area, while in the observation group was evaluated by real-time contrast-enhanced ultrasonography and 3D ultrasound fusion imaging navigation combination. All patients were followed-up for one year, and the one-year overall survival rate in the two groups were recorded and compared. Results The complete ablation rate and supplemental ablation rate in the observation group were 94.1% and 19.6%, significantly higher than 78.4% and 3.9% in the control (P<0.05); after MWA, theincidence of ablation-related complications, such as bleeding, infection, adjacent organ injuries, bile leakage and pleural effusion or ascites in the observation was 17.7%, not significantly different compared to 21.6% in the control (P＞0.05); at the end of one-year follow-up, therecurrence of intrahepatic tumor in the observation was 10.0%, significantly lower than 28.0% in the control group (x²=5.26, P=0.02); the one-year overall survival rate in the observation was 96.0%,significantly higher than 84.0%(Log-Rank x²=22.159, P＜0.001) in the control. Conclusion The guidance of ablation area by real-time contrast-enhanced ultrasonography and 3D ultrasound fusion imaging navigation combination could help evaluate the ablation efficacy of MWA in patients with PLC, and warrants further clinical investigation.

Key words: Hepatoma, Microwave ablation, Real-time contrast-enhanced ultrasonography, 3D ultrasound fusion imaging navigation, Therapy