超声造影时间-强度曲线在肝癌射频消融的应用研究

目的 探讨超声造影时间-强度曲线在肝癌射频消融治疗效果的应用价值.方法 对76例肝癌患者共118个肿瘤病灶行超声引导下射频消融治疗,消融术后1个月使用声学定量分析软件对残余消融灶行动态分析,并与同期增强磁共振成像(MRI)检查结果进行比较,以病理为金标准,对肿瘤残余消融病灶良恶性进行统计对比分析.结果 肝脏射频消融治疗后超声造影疗效的准确性为82.2％,增强MRI为83.9％;超声造影与增强MRI间比较差异无统计学意义(P＞0.05),其检查结果一致性较高;消融术后良性残留消融灶与恶性残留灶血流灌注特点不同,时间强度曲线示峰值强度(IMAX)良性残留消融灶小于恶性残留灶(P＜0.01),峰值强度上升时间(RT)及达峰时间(TTP)良性残留消融灶长于恶性残留灶(P＜0.01);超声造影与增强MRI判断残余病灶良恶性比较差异无统计学意义(P＞0.05).结论 超声造影结合时间强度曲线可以动态、直观、定量地反映灭活灶及良恶性残留灶与周围肝实质血流灌注的差异.

Application study of contrast-enhanced ultrasound time-intensity curve in hepatocellular carcinoma radiofrequency ablation

Objective To investigate the application value of contrast-enhanced ultrasound(CEUS) time-intensity curve in the radiofrequency ablation treatment of hepatocellular carcinoma.Methods Seventy-six patients with hepatocellular carcinoma (118 tumor lesions) conducted the ultrasound-guided radiofrequency ablation therapy.The acoustic quantitative analysis software was employed to dynamically analyze the residual ablation lesions,which were compared with the examination results of synchronous enhanced MRI,with the pathology as the gold standard,the benign and malignant tumor residual ablation lesions were performed the statistically comparative analysis.Results The accuracy of CEUS effect after liver radiofrequency ablation therapy was 82.2 ％,which of enhanced MRI was 83.9 ％;the difference between CEUS and enhanced MRI had no statistical significance(P＞ 0.05),their examination results had higher consistency;the benign residual ablation lesions after radiofrequency ablation had blood perfusion characteristics different from malignant residual lesions,the time-intensity curve showed that IMAX benign residual lesions were smaller than malignant residual lesions(P＜0.01).The benign residual lesions of RT and TTP were longer than the malignant residual lesions(P＜0.01);diagnosing benign and malignant had no statistical difference between CEUS and enhanced MRI (P＞0.05).Conclusion CEUS combined with the time-intensity curve can dynamically,intuitively and quantitatively reflect the blood perfusion differences among inactivated focus,benign and malignant residual lesions,and the surrounding liver parenchyma.