摘要: |
目的 探讨超微血管成像(superb micro-vascular imaging,SMI)技术在评估肝癌射频消融效果中的应用价值。方法 选取35例肝癌患者,共40个肿瘤病灶,分别在经皮射频消融(PRFA)治疗前以及治疗后1个月、3个月、6个月采用彩色多普勒血流显像(CDFI)、SMI和增强CT评估病灶内的血流情况。以Adler半定量法进行分级,以增强CT作为“金标准”,分析SMI技术评估RFA前后病灶内微血管分级与消融效果的相关性。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%),两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CECT具有较好的一致性(P>0.05),并且PRFA治疗前SMI技术分级3级病灶的完全消融率低于1级、2级的病灶,差异均具有统计学意义(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技术对肝癌微血管分级对RFA的疗效具有初步提示作用,具有潜在的临床应用价值。 |
关键词: 超微血管成像 增强CT 肝癌 射频消融 |
DOI: |
投稿时间:2019-03-30修订日期:2019-04-26 |
基金项目:国家自然科学基金青年科学基金项目 |
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The application of the superb micro-vascular imaging in evaluating the therapeutic efficacy of hepatic cancer treated with radiofrequency ablation |
hezipeng,tanghua |
(BEIJING CHAO-YANG HOSPITAL) |
Abstract: |
Objective To evaluate the value of superb micro-vascular imaging in evaluating the therapeutic efficacy of liver cancer treated with radiofrequency ablation(RFA). Methods Thirty-five patients with hepatic cancer(40 lesions) were detected with Color Doppler Flow Imaging(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. Adler semi-quantitative assessment was used for grading, and CECT was used as the gold standard to analyze the correlation between the SMI grading in lesions and ablation effect before and after PFA. Results Before PRFA treatment, SMI showed that 5 lesions(12.5%) were in the first degree, 20 lesions (50.0%) were in the second degree and 15 lesions(37.5) were in the third degree. 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 correlation analysis showed that there was close consistency between the 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(P>0.05). The complete ablation rate of the lesions in the third degree of SMI before RFA treatment was lower than those in the first and second degrees(P<0.05). Conclusions 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. |
Key words: Superb micro-vascular imaging contrast-enhanced computed tomography hepatic cancer Radiofrequency ablation |