CEUS-CT/MRI融合影像虚拟导航在弥漫性肝癌活检中的应用价值  

The application value of CEUS-CT/MRI fusion image virtual navigation in the biopsy of diffuse liver carcinoma

作　　者：李茜 孔文韬[2] 吴杰[2] 闻宝杰[2] 于鹏丽[2] 王文平 LI Qian;KONG Wentao;WU Jie;WEN Baojie;YU Pengli;WANG Wenping(Department of Special Diagnosis,Nanjing Jinling Hospital,Affiliated Hospital of Medical School,Nanjing University,Nanjing 210002,Jiangsu Province,China;Department of Ultrasound,Nanjing Drum Tower Hospital,Affiliated Hospital of Medical School,Nanjing University,Nanjing 210003,Jiangsu Province,China;Department of Ultrasound,Zhongshan Hospital,Fudan University,Shanghai 200032,China)

机构地区：[1]南京大学医学院附属金陵医院特诊科,江苏南京210002 [2]南京大学医学院附属鼓楼医院超声科,江苏南京210003 [3]复旦大学附属中山医院超声科,上海200032

出　　处：《肿瘤影像学》2024年第5期545-550,共6页Oncoradiology

基　　金：江苏省南京市卫生青年人才项目(QXR17011);申康促进市级医院临床技能与临床创新能力三年行动计划重大项目(SHDC2020CR1031B)。

摘　　要：目的:探讨超声造影(contrast enhanced ultrasound,CEUS)-计算机体层成像(computed tomography,CT)/磁共振成像(magnetic resonance imaging,MRI)融合影像虚拟导航在弥漫性肝癌活检中的应用价值。方法:收集南京大学医学院附属鼓楼医院增强CT/MRI检出而常规超声难以显示的弥漫性肝癌患者,运用融合成像技术将超声与增强CT/MRI图像进行融合,并进行超声造影。观察并分析病灶常规超声,超声造影以及CT/MRI图像表现、病灶可见性。患者均在虚拟导航下行经皮肝穿刺活检,总结穿刺成功率。结果:纳入的21例患者均完成CEUS-CT/MRI融合成像,融合成功率100.0%。在常规超声下,21例患者病灶均无法显示;在超声造影中,病灶动脉期显示率为66.7%(14/21),延迟期显示率为47.6%(10/21);21例患者在虚拟导航引导下完成了23例次经皮肝穿刺活检术,首次定位穿刺阳性率为90.5%(19/21),2例假阴性患者在第二次穿刺中取得阳性病理学结果。结论:融合影像虚拟导航技术对常规超声难以显示的弥漫性肝癌具有较高的定位及定性诊断价值。Objective:To explore the application value of contrast-enhanced ultrasound(CEUS)-computed tomography(CT)/magnetic resonance imaging(MRI)fusion image virtual navigation in the biopsy of diffuse liver carcinoma.Methods:Patients with diffuse liver carcinoma detected by contrast-enhanced CT/MRI but not detected by conventional ultrasound in Nanjing Drum Tower Hospital were collected.The images of ultrasound and contrast-enhanced CT/MRI were fused by fusion imaging technology,and then CEUS was performed.The conventional ultrasound,CEUS,CT/MRI images and the visibility of the lesions were observed and analyzed.All patients underwent percutaneous liver biopsy under virtual navigation,and the success rate of puncture was summarized.Results:CEUS-CT/MRI fusion imaging was completed in all 21 cases,and the success rate of fusion was 100.0%.Under conventional ultrasound,none of the 21 cases could be displayed.In CEUS mode,66.7%(14/21)of the lesions were displayed in the arterial phase and 47.6%(10/21)in the delayed phase.Twenty-three percutaneous liver biopsies were performed under the guidance of virtual navigation.The positive rate of the first localization biopsy was 90.5%(19/21),and 2 false negative cases obtained positive pathological results in the second biopsy.Conclusion:Fusion image-guided virtual navigation technology has a high value in the localization and qualitative diagnosis of diffuse liver carcinoma which is difficult to display by conventional ultrasound.

关 键 词：弥漫性肝癌 超声 融合成像 活检 计算机体层成像 磁共振成像 

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