剪切波弹性成像评估肝肿瘤射频消融灶硬度分布的临床研究  

Evaluation of elasticity distribution of the ablation area in the liver tumor by shear-wave elastography

作　　者：苏丽娅[1] 田文硕[1] 林满霞[1] 徐明[1] 张晓儿 刘明[1] 王伟[1] 吕明德[1] 谢晓燕[1] 

机构地区：[1]中山大学附属第一医院超声科,广州510080

出　　处：《中华超声影像学杂志》2016年第8期700-704,共5页Chinese Journal of Ultrasonography

基　　金：国家自然科学基金（81371555）

摘　　要：目的应用剪切波弹性成像（shearwaveelastography，SWE）探讨肝肿瘤消融灶及其周围肝组织的硬度分布。方法对进行肝肿瘤射频消融术的20例患者共20个消融灶，分别于术后2h及1d对消融灶进行SWE及超声造影检查，以超声造影图像中门脉期无增强区为消融灶范围，测量并比较弹性图中相对应消融灶各点及周边肝组织杨氏模量。结果消融后2h及1d，消融灶内部及其周围肝组织以消融灶中心杨氏模量最高，向四周依次减低。消融灶中心、内部、边界、紧邻消融灶肝组织及消融灶外1cm处肝组织于术后2h及术后1d杨氏模量分别为（192．2±32．4）kPa、（183．6±15．9）kPa，（116．7±15．4）kPa、（121．4±12．9）kPa，（61．9±8．7）kPa、（61．8±16．2）kPa，（25．3±7．6）kPa、（26．7±7．0）kPa，（12．9±7．4）kPa、（11．1±6．5）kPa。术后同一时间消融灶各点杨氏模量差异有统计学意义（P〈0．05）。比较消融灶同一点于术后2h及1d的杨氏模量，差异无统计学意义（P〉0．05）。术后2h及1d紧邻消融灶边界处肝组织杨氏模量高于消融灶外1em处肝组织（P〈0．05）。消融术前、消融术后2h及1d，病灶外1cm肝组织杨氏模量分别为（10．7±6．9）kPa、（12．9±7．4）kPa、（11．1±6．5）kPa，差异无统计学意义（P〉0．05）。结论SWE可定量反映消融灶及其周围肝组织硬度分布，术后2h及1d消融灶及其周围肝组织以消融灶中心杨氏模量最高，向四周依次减低。Objective To evaluate the elasticity distribution of the ablation area in the liver tumor by shear wave elastography（SWE）. Methods Twenty cases of hepatic tumor ablations were studied. Both SWE and contrast-enhanced ultrasound （CEUS） images were taken for each ablation zone at 2 hours and 1 day after operation. None enhanced area in the portal phase of CEUS image was considered as the ablation zone. Young modulus of corresponding region of the ablation area were measured. Results Regular elasticity gradient was present in the ablation area at 2 hours and 1 day after operation. Highest Young modulus was observed in the center of the ablation zone and gradually decreased to the normal liver tissue. Young modulus in the center, interior, border of the ablation zone, liver tissue close to the border and the region that 1 cm away from the border were （192.2 ±32.4）kPa ＆ （83.6±15.9）kPa,（116.7 ± 15.44）kPa （121.4±12.9）kPa,（61.9±8.74）kPa ＆ （61.8± 16.2）kPa,（25.3±7.64）kPa ＆ （26.7±7.0）kPa, （12.9 ± 7.44）kPa ＆ （11.1 ± 6.5）kPa, respectively. Significant difference was detected among the Young modulus of all regions in the ablatioin area at the same time point after operation（ P 〈0.05）. But no significant difference was found in the Young modulus of the same region between 2 hours and 1 day after operation（ P 〈0.05）. Liver tisstue close to the ablation border was harder than that at the region of 1 cm away from the border （ P 〈0.05）. No significant difference was detected between the Young modulus of liver tissue before ablation and that at the region of 1 cm away from the ablation zone after operation, which were （10.7±6.9）kPa,（12.9±7.4）kPa,（11.1±6.5）kPa respectively（P 〈0.05）. Conclusions SWE canquantitatively evaluate the elasticity distribution of the ablation area. There is regular elasticity gradient in the ablation area at 2 hours and 1 day after operation, which keeps stable during this time window.

关 键 词：弹性成像技术 射频消融术 肝肿瘤 

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