超微血管成像技术评估肝癌射频消融效果的价值分析  

Application value of superb micro-vascular imaging in evaluating the therapeutic efficacy of hepatic cancer treated by radiofrequency ablation

作　　者：何子朋[1] 蒋鹏程[1] 王志会[1] 董姝英 孔健[2] 唐华[1] HE Zipeng;JIANG Pengcheng;WANG Zhihui;DONG Shuying;KONG Jian;TANG Hua(Department of Ultrasound,the Jingxi Campus of Beijing Chaoyang Hospital,Capital Medical University,Beijing 100043,China)

机构地区：[1]首都医科大学附属北京朝阳医院京西院区超声科,北京100043 [2]首都医科大学附属北京朝阳医院京西院区肝胆胰脾外科,北京100043

出　　处：《临床超声医学杂志》2019年第6期406-409,共4页Journal of Clinical Ultrasound in Medicine

基　　金：国家自然科学基金青年科学基金项目(8180110554、8150110422)

摘　　要：目的探讨超微血管成像(SMI)技术评估肝癌射频消融效果的应用价值。方法选取40例肝癌患者(共40个病灶),分别于经皮射频消融(PRFA)治疗前及治疗后1个月、3个月、6个月使用CDFI、SMI技术和增强CT评估病灶内的血流情况并进行分级;以增强CT检查结果为金标准,分析SMI技术与增强CT评估血管分级及消融效果的一致性。结果PRFA治疗前,SMI技术显示病灶内微血管分级:1级5例(12.5%),2级20例(50.0%),3级15例(37.5%);增强CT显示动脉期轻度强化3例(7.5%),中度强化19例(47.5%),明显强化18例(45.0%),二者具有较好的一致性(Kappa=0.752,P=0.00)。PRFA治疗后,SMI技术评估病灶射频消融效果与增强CT比较差异无统计学意义(χ2=0.560,P=0.521);PRFA治疗前SMI技术评估血流分级为3级的病灶完全消融率低于1级、2级病灶,差异有统计学意义(F=23.270,P<0.05)。结论SMI技术与增强CT对肝癌内微血管评估有较好的一致性,SMI技术微血管分级可有效评估PRFA术后的消融效果,具有潜在的临床应用价值。Objective To evaluate the value of superb micro-vascular imaging(SMI)in evaluating the therapeutic efficacy of liver cancer treated by radiofrequency ablation(RFA).Methods Forty patients with hepatic cancer(40 lesions)were detected by CDFI,SMI and contrast-enhanced CT(CECT)before and 1 month,3 month,6 month after RFA treatment,the blood flow in the lesions were evaluated.CECT was used as the gold standard to analyze the consistency between the SMI grading in lesions and ablation effect. Results Before PRFA treatment,SMI showed that 5 lesions(12.5%)were in grade Ⅰ,20 lesions (50.0%)were in grade Ⅱ and 15 lesions(37.5)were in grade Ⅲ.During the arterial phase,CECT showed that 3 lesions(7.5%) were mild enhancement,19 lesions(47.5%)were moderate enhancement and 18 lesions(45.0%)were apparente enhancement. The consistency analysis showed that there was high consistency between SMI and CECT(Kappa=0.752,P=0.00). After PRFA treatment,there was no statistical difference between SMI and CECT in evaluating the therapeutic efficacy of RFA(χ2=0.560,P= 0.521).The complete ablation rate of the lesions in grade Ⅲ of SMI before RFA treatment was lower than that in grade Ⅰ and grade Ⅱ,there was significant difference(F=23.270,P<0.05). Conclusion SMI has a good consistency with CECT in evaluating the blood flow signal of liver cancer.The microvascular grading of SMI technology has preliminary implications for the therapeutic efficacy of RFA and has potential clinical reference values.

关 键 词：超微血管成像 增强CT 射频消融 肝癌 

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]