声脉冲辐射力弹性成像声触诊组织定量技术评价肝癌射频消融疗效的初步研究  

Visualization of radiofrequency ablation treated hepatocellular carcinoma lesions by virtual touch tissue quantification of acoustic radiation force impulse elastography

作　　者：陈洁鑫[1] 周宏莲[1] 李明意[2] 陈念平[2] 徐晓红[1] 

机构地区：[1]广东医学院附属医院超声科,广东省湛江市524001 [2]广东医学院附属医院肝胆外科,广东省湛江市524001

出　　处：《临床超声医学杂志》2015年第7期461-464,共4页Journal of Clinical Ultrasound in Medicine

摘　　要：目的探讨声脉冲辐射力弹性成像声触诊组织定量（VTQ）技术在肝癌射频消融（RFA）疗效评价中的价值。方法在我院行RFA的62例肝癌患者共72个病灶为研究对象,术后20～40 d以常规超声、超声造影、VTQ及增强CT进行疗效评价。应用VTQ技术定量检测肝癌病灶RFA术前和术后的组织硬度,比较治疗前后的剪切波速度（SWV）。以增强CT结果为标准,评估VTQ技术在肝癌RFA术后疗效诊断中的应用价值。结果 VTQ检测64个消融完全的肝癌消融前后的SWV值分别为（2.65±0.58）m/s和9.00 m/s,差异有统计学意义（P〈0.05）;8个术后局部残留病变消融前后的SWV值分别为（2.43±0.29）m/s和（2.50±0.25）m/s,差异无统计学意义。以增强CT为标准：72个肝癌病灶RFA后9个残留,63个完全消融。VTQ诊断消融后残留病灶的敏感性、特异性和准确性分别为77.8%、98.4%和95.8%,超声造影分别为100%、96.9%和97.2%;VTQ与增强CT检查结果一致性好（Kappa=0.800,P〈0.05）。结论 VTQ技术能反映消融灶的组织硬度,辅助识别残存肿瘤,对评价肝癌RFA疗效有重要价值。Objective To investigate the clinical value of virtual touch tissue quantification（VTQ） of acoustic radiation force impulse（ARFI） elastography in evaluating the therapeutic effect of radiofrequency ablation（RFA） for hepatocellular carcinoma.Methods A total of 62 patients with 72 hepatocellular carcinoma lesions after RFA were examined with gray-scale ultrasound,virtual touch tissue quantification（VTQ）,contrast-enhanced ultrasonography（CEUS）and contrast enhanced CT（CECT）.The stiffness of the lesions was evaluated by measuring shear wave velocity（SWV）with VTQ before and after performing RFA.Taking the results of CT as standard,the application value of VTQ in evaluating the therapeutic effect of RFA was assessed.Results In 64 ablated lesions,the SWVs were（2.65±0.58）m/s and 9.00 m/s before and after RFA,and the data showed significant difference（P〈0.05）.In 8 residual lesions,the mean SWVs were（2.43±0.29）m/s and（2.50±0.25）m/s before and after RFA,and there was no significant difference.According to the results of CECT,63 lesions were completely ablated,and 9 were residual.The sensitivity,specificity and accuracy of VTQ and CEUS for residual lesions were 77.8%,98.4%,95.8% and 100%,96.9%,97.2%,respectively.VTQ results has good consistency with those of CECT（Kappa=0.800,P〈0.05）.Conclusion VTQ of ARFI elastography can reflects the stiffness of ablated lesions and help to identify the residual lesions,it plays an important role in assessing the therapeutic response to RFA of hepatocellular carcinoma.

关 键 词：声脉冲辐射力 超声检查 弹性成像 射频消融术 肝癌 

分 类 号：R575.5[医药卫生—消化系统] R445.1[医药卫生—内科学]