实时三维超声造影在肝癌射频消融术前病灶形态学评估中的应用价值  

Application value of real-time three-dimensional contrast-enhanced ultrasound for morphological assessing of hepatocellular carcinoma before radiofrequency ablation treatment

作　　者：汪贤臣 李世岩[2] 方勇[3] 周凌 许立龙[2] 吴垚 Wang Xianchen, Li Shiyan, Fang Yong, Zhou Ling, Xu Lilong, Wu Yao(Department of Ultrasound, Hangzhou Xiasha Hospital, Xiasha Campus of Sir Run Run Shaw Hospital, Zhejiang University, School of Medicine, Hangzhou 310018, China; Department of Ultrasound, Sir Run Run Shaw Hospital, Zhejiang University, School of Medicine, Hangzhou 310016, China ; Department of Oncology , Sir Run Run Shaw Hospital, Zhejiang University, School of Medicine, Hangzhou 310016, Chin)

机构地区：[1]杭州市下沙医院浙江大学医学院附属邵逸夫医院下沙院区超声科,310018 [2]浙江大学医学院附属邵逸夫医院超声科,杭州310016 [3]浙江大学医学院附属邵逸夫医院肿瘤内科,杭州310016

出　　处：《中华肿瘤杂志》2018年第3期217-221,共5页Chinese Journal of Oncology

基　　金：国家自然科学基金青年科学基金项目(81402569);浙江省医药卫生一般研究计划(2014KYB128)

摘　　要：目的探讨实时三维超声造影（RT－3D－CEUS）在肝癌射频消融（RFA）术前对病灶形态的评估能力。方法选择在杭州市下沙医院接受RFA治疗的60例肝癌患者（88个目标病灶）为研究对象，对其术前超声造影（CEUS）和RT－3D－CEUS资料进行回顾性分析，通过观察病灶的大小和形态，比较两种检查显示病灶形态学特征的能力，并与术后肿瘤发生残留情况进行对比分析。结果在入选的88个目标病灶中，有70个CEUS测量病灶大小与RT－3D－CEUS相当（A组），另外18个RT－3D－CEUS测量的病灶大小较CEUS更大（B组）。CEUS显示病灶为类圆形38个，椭圆形47个，不规则形3个。而RT－3D－CEUS显示病灶为类圆形34个，椭圆形41个，不规则形13个。其中78个CEUS与RT－3D－CEUS显示病灶形态一致（A′组），另外10个病灶两种检查方法显示病灶形态不一致（B′组）。与术后3个月复查结果比较，A组病灶中经RFA治疗后仍有4个（5.7%）病灶肿瘤残留，而B组中有6个（33.3%）病灶残留，两组病灶肿瘤残留率之间的差异有统计学意义（P＝0.004）。A′组病灶中经RFA治疗后仍有6个（7.7%）病灶肿瘤残留，而B′组中有4个（40.0%）病灶残留，两组病灶肿瘤残留率之间的差异有统计学意义（P＝0.012）。结论RT－3D－CEUS可以从大小和形态方面对肝癌病灶的形态学特征进行更为准确地描述，病灶的形态学特征对其RFA术后肿瘤残留有一定影响。ObjectiveTo investigate the evaluating ability of real-time three-dimensional contrast-enhanced ultrasound （RT-3D-CEUS） for morphology of hepatocellular carcinoma （HCC） before radiofrequency ablation （RFA） treatment.MethodsSixty patients with 88 targeted lesions were enroll in this study, who have received RFA in Hangzhou Xiasha Hospital. The pretreatment imaging data of CEUS and RT-3D-CEUS were retrospective analysis. Morphological features were assessed according to the size and shape of the lesions, and were compared between two modalities with the post-treatment response as the reference standard.ResultsThe size of lesion measured by CEUS and RT-3D-CEUS was similar in 70 out of 88 lesions （group A）. In the other 18 lesions, the size measured by RT-3D-CEUS was larger than that by CEUS （group B）. For the shape analysis, 38 lesions were spheroid by CEUS and 34 lesions by RT-3D-CEUS; 47 lesions were oval by CEUS and 41 lesions by RT-3D-CEUS; 3 lesions were irregular by CEUS and 13 lesions by RT-3D-CEUS. There were 78 lesions which shape assessed by two modalities consistently （group A′）, and the other 10 lesions with inconsistent shape by two modalities （group B′）. Three months follow-up results showed that 4 lesions appeared tumor residue （5.7%） in group A′ and 6 lesions （33.3%） in group B′. There was significant difference between these two groups （P=0.004）. In the group A′, there were 6 lesions （7.7%） showed tumor residue, and 4 lesions （40.0%） in group B′. The difference between these two groups was also significant （P=0.012）.ConclusionRT-3D-CEUS could be used to assess the size and shape of HCC accurately which is associated with the response of RFA.

关 键 词：肝肿瘤:超声造影 三维成像 射频消融 

分 类 号：R445.1[医药卫生—影像医学与核医学] R735.7[医药卫生—诊断学]