超声造影评价肝肿瘤射频治疗疗效的实验研究  

The Experimental Study of Contrast Enhanced Ultrasonography on Assessing the Effect of Radiofrequency Ablation for Hepatic Tumor

作　　者：丁建民[1] 经翔[1] 张翔[2] 张勤[3] 张倩华[1] 

机构地区：[1]天津市第三中心医院超声科,300170 [2]天津市第三中心医院放射科,300170 [3]天津市第三中心医院病理科,300170

出　　处：《天津医药》2011年第7期628-630,674,共4页Tianjin Medical Journal

基　　金：天津市卫生局科技基金资助项目(项目编号:06KZ16)

摘　　要：目的:分析兔肝VX2肿瘤射频消融(RFA)后超声造影(CEUS)与增强CT(CECT)、病理结果之间的关系,探讨CEUS评价RFA疗效的可靠性。方法:建立兔肝VX2肿瘤模型进行RFA治疗。RFA后1周行CEUS、CECT及病理学检查,对3种检查方法的结果进行比较。结果:30只瘤兔30个肿瘤RFA后22个残留,8个完全消融。CEUS测得消融灶的平均最大径、垂直径和面积分别为(1.37±0.34)cm、(1.02±0.37)cm和(1.52±0.90)cm2,CECT的测值为(1.32±0.37)cm、(0.95±0.37)cm和(1.38±0.88)cm2,病理标本测值为(1.27±0.35)cm、(0.94±0.34)cm和(1.31±0.77)cm2,3组比较差异均无统计学意义。以病理结果为金标准,CEUS与CECT诊断残瘤的敏感性、特异性和准确性分别为90.9%、75.0%、86.7%和86.4%、87.5%、86.7%。结论:CEUS对微血管具有高度敏感性,能较准确地判断RFA后毁损区的范围,识别残存肿瘤,为肝癌的后续治疗提供可靠依据。Objective：To analyze the correlation between contrast enhanced ultrasonography（CEUS）,contrast enhanced CT（CECT） and histopathologic examination after radiofrequency ablation（RFA） in hepatic VX2 tumor of rabbits,and explore the reliability of CEUS in assessing the tumor response after RFA.Methods：RFA was applied to the rabbit model of hepatic VX2 tumor.Both CEUS and CECT were performed 1 week after RFA.The results of CEUS,CECT and histopathologic examinations were compared.Results：In 30 rabbits of hepatic VX2 tumor,residual viable tumors were found in 22 rabbits and no residual tumors were seen in 8 rabbits after RFA according to histopathologic results.The average largest diameter and perpendicular diameter and area of ablation areas were（1.37±0.34） cm,（1.02±0.37） cm and（1.52±0.90） cm2 measured by CEUS,respectively.Those of ablation areas were（1.32±0.37） cm,（0.95±0.37） cm,（1.38±0.88） cm2 measured by CECT,and（1.27±0.35） cm,（0.94±0.34） cm and（1.31±0.77） cm2 detected by histopathology,respectively.According to the results of histopathology,the sensitivity,specificity and accuracy for evaluating therapeutic effect were 90.9%,75.0% and 86.7% for CEUS and 86.4%,87.5%,86.7% for CECT,respectively.Conclusion：CEUS is sensitive to capillary vessel,which can accurately discriminate the coagulation necrosis from residual tumors after RFA and offer the reliable foundation for subsequent treatment.

关 键 词：肝肿瘤 实验性 导管消融术 超声检查 造影剂 体层摄影术 X线计算机 兔 

分 类 号：R735.7[医药卫生—肿瘤]