超声造影定量分析技术在早期鉴别兔VX2肝肿瘤消融后残癌与炎症带中的应用价值  

Early differentiation of residual tumor and inflammation rim after ablation of rabbit VX2 liver tumor by quantitative analysis of contrast-enhanced ultrasound

作　　者：韩红 金赟杰 刘嵘 范卓阳 季正标 王文平 HAN Hong;JIN Yun-jie;LIU Rong;FAN Zhuo-yang;JI Zheng-biao;WANG Wen-ping(Department of Ultrasound,Zhongshan Hospital,Fudan University,Shanghai 200032,China;Shanghai Institute of Medical Imaging,Shanghai 200032,China;Department of Interventional Radiology,Zhongshan Hospital,Fudan University,Shanghai 200032,China)

机构地区：[1]复旦大学附属中山医院超声科,上海200032 [2]上海市影像医学研究所,上海200032 [3]复旦大学附属中山医院介入治疗科,上海200032

出　　处：《复旦学报（医学版）》2022年第1期44-49,共6页Fudan University Journal of Medical Sciences

基　　金：上海市自然科学基金(19ZR1450700);上海市临床重点专科项目(shslczdzk03501);促进市级医院临床技能与临床创新能力三年行动计划(SHDC2020CR1031B)。

摘　　要：目的探讨超声造影定量分析技术在早期鉴别兔VX2肝肿瘤激光消融后癌残留与灶周炎症带中的价值。方法取新西兰大白兔16只,在兔肝种植VX2瘤后制作肿瘤部分消融模型。在消融后1、3、7、14天对肿块区进行超声造影检查,超声检查仪器为东芝Aplioi900超声诊断仪,造影剂为SonoVue。参照最终病理结果,回放定帧图像,分别在残癌组织、炎症带中选取兴趣区进行定量分析检查。比较残癌与消融后炎症反应带的时间-强度曲线形态及各定量参数值差异。结果在消融术后不同时间段共划定兴趣区70个,包括残癌34个和炎症带36个。残癌与消融灶周炎症带的时间-强度曲线形态不同:残癌的时间-强度曲线形态以速升速降型为主(22/34,64.7%),而炎症带则多表现为速升缓降型(20/36,55.6%)(P=0.002)。消融术后第3天,残癌与炎症带两组超声造影定量参数差异最明显,表现为峰值强度、达峰时间、平均渡越时间、曲线下面积、上升支曲线下面积及下降支曲线下面积等差异均有统计学意义(P均<0.05)。结论超声造影定量分析技术可帮助早期鉴别兔VX2肝肿瘤消融术后癌残留及灶周炎症带。Objective To explore the value of quantitative analysis technique of contrast-enhanced ultrasound in early differentiation of residual tumor from inflammatory rim after laser ablation of rabbit VX2liver tumors.Methods VX2 tumors were implanted on the livers of 16 New Zealand white rabbits,followed by laser ablation to create a partial ablation model of liver tumors.And then contrast-enhanced ultrasonography was performed at 1,3,7,and 14 days after ablation.The examination instrument was Toshiba Aplioi900 ultrasonic apparatus,and the ultrasonic contrast agent was Sono Vue.Referring to the final pathological specimen,the images were replayed,and the regions of interest(ROI)were selected in normal liver,residual tumor,and hyperemic inflammatory rim for quantitative analysis respectively.The morphology of the time intensity curve(TIC)and the differences in the values of each quantitative parameter were compared between the residual tumor and the hyperemic inflammatory rim after ablation.Results A total of 70 ROI were delineated at different time points of 1,3,7 and 14 days after ablation,including 34 residual tumors and 36 inflammatory zones.The morphology of TIC was different between the residual tumor and the inflammatory rim around the ablation zone.The most common TIC morphology of contrast-enhanced ultrasound in residual tumor was the rapid rise and rapid fall type(22/34,64.7%),while that of inflammation zone was the rapid rise and slow fall type(20/36,55.6%)(P=0.002).On the third day after ablation,the quantitative parameters of contrast-enhanced ultrasound including peak intensity,time to peak,mean transit time,area under the curve,area under the curve of wash in and area under the curve of wash out were significantly different between the residual tumor and inflammatory zone(all P<0.05).Conclusion Quantitative analysis of contrast-enhanced ultrasound has certain value in early differentiation of residual tumor and inflammatory rim after ablation of rabbit VX2 liver tumors.

关 键 词：消融 残余肿瘤 炎症 肝癌 超声造影 定量分析 

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