实时影像融合介入导航系统在小肝癌微波消融中应用评价  

Clinical application of real-time image fusion interventional navigation system in microwave ablation of small hepatocellular carcinoma

作　　者：邱金霞 尹永波 鲁北[1] 陈威[1] QIU Jinxia;YIN Yongbo;LU Bei;CHEN Wei(Department of Radiology,Xingtai Municipal People's Hospital,Xingtai,Hebei Province 054001,China)

机构地区：[1]邢台市人民医院放射科,河北邢台054001 [2]邢台市人民医院耳鼻喉科,河北邢台054001

出　　处：《介入放射学杂志》2023年第7期663-667,共5页Journal of Interventional Radiology

基　　金：河北省卫生健康委医学科学研究课题计划项目(20150788)。

摘　　要：目的评价实时影像融合介入导航系统在小肝癌微波消融中的应用。方法选择2019年12月至2021年12月在邢台市人民医院接受实时影像融合介入导航系统辅助微波消融治疗的64例小肝癌患者作为研究组,同时段未接受实时影像融合介入导航系统辅助的52例小肝癌患者作为对照组。研究组在微波消融前分别采用常规超声、实时影像融合介入导航系统、增强CT/MRI扫描病灶,对照组仅行常规超声检查,计算检出率。微波消融手术在实时影像融合介入导航系统导引下进行。术后1个月行常规超声、实时影像融合介入导航系统、增强CT/MRI检查,计算各项影像学技术的特异度、灵敏度与准确度。术后1年评估两组疗效。结果实时影像融合介入导航系统对病灶最长径的测量值大于常规超声(t=3.887,P<0.01),与增强CT/MRI的测量值差异无统计学意义(t=0.119,P=0.905);常规超声、实时影像融合介入导航系统检出率分别为95.83%、100%。实时影像融合导入系统与增强CT/MRI对小肝癌疗效的评估呈良好一致性(Kappa=0.529,P<0.01)。术后1年,研究组客观缓解率(ORR)、疾病控制率(DCR)均高于对照组(P<0.05)。结论实时影像融合介入导航系统在小肝癌微波消融治疗中具有重要作用,可精准评估病灶位置、数量及大小,用于术后随访的准确度、灵敏度及特异度均较高。Objective To evaluate the clinical application of real-time image fusion interventional navigation system in microwave ablation(MWA)of small hepatocellular carcinoma(HCC).Methods A total of 64 patients with small HCC,who received MWA with the help of real-time image fusion interventional navigation system at the Xingtai Municipal People's Hospital of China between December 2019 and December 2021,were collected and used as the study group,and other 52 patients with small HCC,who received MWA with no use of real-time image fusion interventional navigation system during the same time period as the above,were collected and used as the control group.Before MWA,for the patients of the study group the conventional ultrasound,real-time image fusion interventional navigation system,and enhanced CT/MRI scan were separately performed to display the lesions,while for the patients of the control group only the conventional ultrasound was carried out,and the detection rate of lesions was calculated.Under the guidance of the real-time image fusion interventional navigation system,the MWA procedure was accomplished.One month after MWA,conventional ultrasound,real-time image fusion interventional navigation system,and enhanced CT/MRI examinations were performed to calculate the specificity,sensitivity and accuracy of various imaging techniques.One year after MWA,the curative efficacy in the two groups was evaluated.Results The lesion’s longest diameter measured by real-time image fusion interventional navigation system was greater than that measured by conventional ultrasound(t=3.887,P<0.01).No statistically significant difference in the lesion’s longest diameter existed between real-time image fusion interventional navigation system and contrast-enhanced CT/MRI scan(t=0.119,P=0.905).The lesion’s detection rates of conventional ultrasound and real-time image fusion interventional navigation system were 95.83%and 100.00%respectively.In evaluating the curative effect of small HCC,the real-time image fusion system had a good c

关 键 词：实时影像融合介入导航系统 导航系统 肝癌 微波消融 增强CT/MRI 

分 类 号：R735.7[医药卫生—肿瘤]