三维超声造影融合成像评估肝癌射频消融安全边界的价值  

The value of three-dimensional contrast-enhanced ultrasound fusion imaging in evaluating the ablation margin of radiofrequency ablation for hepatocellular carcinoma

作　　者：周小郁 黄光亮[1] 叶洁仪 张晓儿 丛龙飞 谢晓华[1] 谢晓燕[1] Zhou Xiaoyu;Huang Guangliang;Ye Jieyi;Zhang Xiaoer;Cong Longfei;Xie Xiaohua;Xie Xiaoyan(Department of Medical Ultrasonics,Division of Interventional Ultrasound,Institute of Diagnostic and Interventional Ultrasound,the First Affiliated Hospital of Sun Yat-sen University,Guangzhou 510080, China;Shenzhen Mindray Bio-medical Electronics.LTD,Shenzhen 518000,China)

机构地区：[1]中山大学附属第一医院超声医学科中山大学超声诊断与介入超声研究所,广州510080 [2]深圳迈瑞生物医疗电子股份有限公司技术研究所,518000

出　　处：《中华超声影像学杂志》2019年第2期103-107,共5页Chinese Journal of Ultrasonography

摘　　要：目的探讨三维超声造影(3DCEUS)评估肝癌射频消融安全边界的价值。方法采集60例患者60个病灶消融术前后的3DCEUS图像,通过自主研发的3DCEUS融合成像技术评估安全边界,并分析其与CT融合成像评估安全边界的一致性。对包括安全边界在内的多个肿瘤局部进展(LTP)的危险因素进行分析。结果3DCEUS融合成像配准成功率为96.7%(58/60),安全边界<5mm组31例,安全边界≥5mm组27例。3DCEUS与CT融合成像评估安全边界的一致性较好(Kappa=0.895,P<0.001)。随访4.2~18.0个月,有5例发生LTP(8.6%,5/58),安全边界<5mm的LTP发生率高于安全边界≥5mm(P=0.033)。结论3DCEUS融合成像可在肝癌射频消融后及时评估安全边界,与CT融合成像具有较好的一致性,可预测LTP的发生。Objective To compare three-dimensional contrast-enhanced ultrasound (3DCEUS) fusion imaging and computed tomography (CT) fusion imaging in evaluating ablation margin (AM) after radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC). Methods The 3DCEUS images of 60 patients before and after RFA were collected. The AM was evaluated by the self-developed 3DCEUS fusion imaging technique. The consistency of AM evaluation was compared between 3DCEUS and CT fusion imaging. The risk factors of local tumor progression (LTP) including AM were analyzed. Results The registration success rate of 3DCEUS fusion imaging was 96.7% (58/60). Thirty-one cases were in the AM<5 mm group, and 27 cases were in the AM≥5 mm group. The consistency of AM evaluation between 3DCEUS and CT fusion imaging was good (Kappa coefficient=0.895, P<0.001). During a follow-up period ranging 4.2 to 18 months, LTP was identified in 5 tumors (8.6%, 5/58). The incidence of LTP with the AM<5 mm was higher than that with the AM≥5 mm(P=0.033). Conclusions 3DCEUS fusion imaging is feasible for AM evaluation immediately after RFA with high consistency with CT fusion imaging. AM<5 mm evaluated on 3DCEUS fusion immediately after RFA is a risk factor for LTP.

关 键 词：超声造影 三维 癌 肝细胞 融合成像 射频消融术 

分 类 号：R735.7[医药卫生—肿瘤] R445.1[医药卫生—临床医学]