实时超声弹性成像在体表复杂动静脉畸形射频消融疗效评估中的价值  

The value of real-time ultrasound in evaluating the effect of radiofrequency ablation for complex arteriovenous malfor⁃mations on the body surface

作　　者：周洪珍 张涛 郭磊 何兴振 ZHOU Hongzhen;ZHANG Tao;GUO Lei;HE Xingzhen(Department of Ultrasound Medicine,Linyi Cancer Hospital,Linyi 276034,China)

机构地区：[1]山东省临沂市肿瘤医院超声医学科,山东临沂276034

出　　处：《医学影像学杂志》2025年第3期100-103,共4页Journal of Medical Imaging

基　　金：山东省临沂市科技发展计划项目(编号:201919055)。

摘　　要：目的 探讨实时超声弹性成像在体表复杂动静脉畸形(AVMs)射频消融术后疗效评估中的应用价值。方法选取我院收治的42例复杂AVMs患者的临床资料,在常规超声和实时弹性成像的引导下进行射频消融,采用5分法进行病灶硬度评分,并通过Q-analysis曲线得出病变的弹性比率值(E值)。在实时超声监测下进行射频消融术,术后即时(1/2小时)及术后3个月对消融效果进行评估,分析病灶的弹性图谱和E值的变化,结果与强化CT/CTA进行对比。结果 42例复杂AVMs共完成118次射频消融。通过Wilcoxon秩和检验分析,术前、术后即时及术后3个月的弹性图谱特征对比显示,差异具有统计学意义(F=127.788、173.956、11.699,P<0.01);术前、术后即时及术后3个月E值的变化差异具有统计学意义(t=30.567、64.803、37.718,P<0.001)。弹性成像评估的有效率为83.3%(35/42),而强化CT/CTA评估的有效率为85.7%(36/42),两者差异无统计学意义(P>0.05)。结论 实时超声弹性成像在评估病灶硬度变化方面具有优势,射频治疗后病灶硬度增加,与临床触诊一致,实时弹性成像是AVMs射频消融后疗效评估的有效手段。Objective To explore the application value of real-time ultrasound in evaluating the efficacy of radiofrequency ablation for complex arteriovenous malformations on the body surface.Methods The Clinical data of 42 patients with complex AVMs admitted to our hospital were selected,and radiofrequency ablation was performed under the guidance of conventional ul-trasound and real-time elastography.The lesion hardness score was evaluated using a 5-point method,and the elasticity ratio(E value)of the lesion was obtained through Q-analysis curve.Then,we evaluated the ablation effect immediately(1/2 hour)and 3 months after radiofrequency ablation under real-time ultrasound monitoring,analyzed the changes in the elastic spectrum and E value of the lesion,and compare compared the results with enhanced CT/CTA.Results A total of 118 radiofrequency ab-lation sessions were completed for 42 complex AVMs.Through Wilcoxon rank sum test analysis,the comparison of elastography characteristics before surgery,immediately after surgery,and 3 months after surgery showed statistically significant differences(F=127.788,173.956,11.699,P<0.01);There was a statistically significant difference in the changes of E values before sur-gery,immediately after surgery,and 3 months after surgery(t=30.567,64.803,37.718,P<0.001).The effective rate of elastog-raphy evaluation was 83.3%(35/42),while the effective rate of enhanced CT/CTA evaluation was 85.7%(36/42),with no sta-tistically significant difference between the two(P>0.05).Conclusion Real time ultrasound has advantages in evaluating changes in lesion hardness,after radiofrequency treatment,lesion hardness increases,being consistent with clinical palpation.Real time elastography is an effective means of evaluating the efficacy of AVMs after radiofrequency ablation.

关 键 词：动静脉畸形 实时超声弹性成像 射频消融术 疗效评估 

分 类 号：R732.2[医药卫生—肿瘤] R445.1[医药卫生—临床医学]