超声造影在评价介入栓塞术后肝癌病灶中的价值
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摘要
目的:评价超声造影方法能否准确评估介入栓塞术后的肝癌病灶是否存活。方法:选择肝癌介入栓塞术后的病例入组,并对病灶进行增强CT和超声造影检查。以大体病理或增强MR结果为金标准,将增强CT和超声造影的评价结果作比较。结果:共纳入患者65例共81个病灶,以诊断病灶有存活为指标,增强CT的敏感性、特异性及准确性分别为:63.0%、100%及66.7%,超声造影的敏感性、特异性及准确性分别为:97.3%、100%及97.5%,超声造影和增强CT相比结果有统计学差异(P<0.01)。结论:超声造影方法可以对介入栓塞术后的肝癌病灶是否存活进行准确评估。
Objective: To evaluate whether the viability of hepatocellular carcinoma(HCC) after transcatheter arterial chemoembolization(TACE) could be accurately assessed by contrast enhanced ultrasound(CEUS). Methods: The HCC patients after TACE were enrolled. All the patients received contrast enhanced CT and CEUS and the results of these two methods were compared.The gross specimen or contrast enhanced MR was set as golden standard in the study. Results: The 65 patients with 81 HCC lesions were enrolled. The sensitivity, specificity and accuracy of contrast enhanced CT and CEUS were 63.0%, 100%, 66.7% and 97.3%,100%, 97.5% separately in diagnosing the viability of HCC lesion. The difference between the two methods was significant(P <0.01).Conclusion: The viability of hepatocellular carcinoma(HCC) after transcatheter arterial chemoembolization(TACE) could be accurately assessed by contrast enhanced ultrasound(CEUS).
Objective: To evaluate whether the viability of hepatocellular carcinoma(HCC) after transcatheter arterial chemoembolization(TACE) could be accurately assessed by contrast enhanced ultrasound(CEUS). Methods: The HCC patients after TACE were enrolled. All the patients received contrast enhanced CT and CEUS and the results of these two methods were compared.The gross specimen or contrast enhanced MR was set as golden standard in the study. Results: The 65 patients with 81 HCC lesions were enrolled. The sensitivity, specificity and accuracy of contrast enhanced CT and CEUS were 63.0%, 100%, 66.7% and 97.3%,100%, 97.5% separately in diagnosing the viability of HCC lesion. The difference between the two methods was significant(P <0.01).Conclusion: The viability of hepatocellular carcinoma(HCC) after transcatheter arterial chemoembolization(TACE) could be accurately assessed by contrast enhanced ultrasound(CEUS).
引文
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[13]Rodriguez-Peralvarez M,Luong T V,Andreana L,et al.A systematic review of microvascular invasion in hepatocellular carcinoma:diagnostic and prognostic variability[J].Ann Surg Oncol,2013,20(1):325-339.
[14]高云,郑晓林,杨沛钦,等.探讨MRl连续动态增强对肝癌的诊断价值及与常规CT多期增强的比较[J].中国CT和MRI杂志,2017,5(15):92-95.
[15]王莉,赵冬梅,韩福刚.磁共振成像评价肝癌TACE术后疗效的应用进展[J].中国临床医学影像杂志,2016,27(2):135-137.
[16]肖彬,王春瑜,曹阳,等.超声造影与增强CT评价经皮射频消融治疗肝癌术后近期疗效的对比研究[J].广西医学,2015,37(7):931-934.
[2]Fitzmaurice C,Dicker D,Pain A,et a1.The Global Burden of Cancer 2013[J].JAMAOncol,2015,1(4):505-27.
[3]冯凯,马宽生,别平.射频消融技术在肝癌综合治疗中合理应用[J].中国实用外科杂志,2016,36(6):621-623.
[4]Forner A,Llovet JM,Bruix J.Hepatocellular carcinoma[J].Lancet,2012,379(9822):1245-1255.
[5]Nakazawa T,Hidaka H,Shibuya A,et al.Overall survival in response to sorafenib versus radiotherapy in unresectable hepatocellular carcinoma with major portal vein tumor thrombosis:propensity score analysis[J].BMC Gastroenterol,2014(14):84.
[6]Liu L,Zhang C,Zhao Y,et al.Transarterial chemoembolization for the treatment of advanced hepatocellular carcinoma with portal vein tumor thrombosis:prognostic factors in a single-center study of 188 patients[J].Biomed Res Int,2014:194278.
[7]Donadon M,Solbiati L,Dawson L,et al.Hepatocellular carcinoma:the role of interventional oncology[J].Liver Cancer,2016,6(1):34-43.
[8]Tsochatzis EA,Fatourou E,O'Beirne J,et al.Transarterial chemoembolization and bland embolization for hepatocellular carcinoma[J].World J Gastroenterol,2014,20(12):3069-3077.
[9]Miyayama S,Matsui O.Superselective conventional transarterial chemoembolization for hepatocellular carcinoma:rationale,technique,and outcome[J].J Vasc Interv Radiol,2016,27(9):1269-1278.
[10]虞梅,梅琪,倪娟,等.肝超声造影监测和早期诊断微小肝癌的应用价值[J].中国癌症杂志,2014,24(3):203-207.
[11]韦柳,李智贤,彭涛,等.超声造影对不同病理类型及分化程度原发性肝癌的诊断价值[J].中华肝脏病杂志,2012,20(12):939.
[12]Salvatore V,Borghi A,Sagrini E,et al.Quantification of enhancement of focal liver lesions during contrast-enhanced ultrasound(CEUS).Analysis of ten selected frames is more simple but as reliable as the analysis of the entire loop for most parameters[J].Eur JRadiol,2012,81(4):709-713.
[13]Rodriguez-Peralvarez M,Luong T V,Andreana L,et al.A systematic review of microvascular invasion in hepatocellular carcinoma:diagnostic and prognostic variability[J].Ann Surg Oncol,2013,20(1):325-339.
[14]高云,郑晓林,杨沛钦,等.探讨MRl连续动态增强对肝癌的诊断价值及与常规CT多期增强的比较[J].中国CT和MRI杂志,2017,5(15):92-95.
[15]王莉,赵冬梅,韩福刚.磁共振成像评价肝癌TACE术后疗效的应用进展[J].中国临床医学影像杂志,2016,27(2):135-137.
[16]肖彬,王春瑜,曹阳,等.超声造影与增强CT评价经皮射频消融治疗肝癌术后近期疗效的对比研究[J].广西医学,2015,37(7):931-934.