兔VX2肝肿瘤射频消融疗效评价--超声造影、增强CT与病理对比研究

Assessment of the Effect of Hepatic VX2 Carcinoma in a Rabbit Model Treated by Radiofrequency Ablation:Correlation with Contrast-enhanced Ultrasonography,CT and Histopathology

目的探讨超声造影(CEUS)与增强CT检查在评价肝肿瘤VX2肝肿瘤模型射频消融(RFA)疗效方面的作用。资料与方法9只兔VX2肝肿瘤模型作RFA治疗后1周同时作CEUS与增强CT检查,与病理作对照,比较CEUS与增强CT在评价RFA疗效的准确性。结果9只中8只病理发现残留肿瘤灶,1只完全消融,残留灶在CEUS与增强CT上均可见强化。3只炎性反应带能被CEUS正确评价,而增强CT将其中2只误认为是残留灶。1只残留灶位于肋骨下未能被CEUS检出。CEUS、增强CT、两者联合诊断的敏感率、特异性和诊断准确率分别为86%、88%、86%,90%、78%、85%,94%、75%、91%。三组之间差异均无统计学意义(P<0.05)。结论CEUS与增强CT均能较可靠评价RFA疗效,两者具有良好的相关性和一致性;CEUS与增强CT联合评价可提高评价准确率。

Objective To evaluate the role of contrast-enhanced ultrasonography （CEUS） and postcontrast CT in the assessment of the therapeutic effect of radiofrequency ablation （RFA） in a rabbit model with hepatic VX2 tumor. Mated- als and Methods Both CEUS and CT were performed 4 days after RFA in 9 rabbit models with hepatic VX2 carcinoma treated with RFA followed by hiostopathological examination. CEUS and CT findings were analyzed correlated with pathologi- cal results. Results Residual viable tumors were found in 8 models after RFA showing enhancement on both CEUS and CT and no residual tumor was seen in one case. Inflammatory hyperplasia was detected on CEUS in 3 cases, in which inflam- matory hyperplasia was misdiagnosed as a residual tumor on CT in 2 cases. One residual viable tumor below the rib was missed by CEUS. The sensitivity, specificity, and accuracy of CEUS was 86% ,88% , and 86% , respectively. The sensitivity, specificity, and accuracy of CT was 90% , 78 % , and 85 % , respectively. The sensitivity, specificity, and accuracy of combina- tion of CEUS and CT was 94% ,75 % , and 91%, respectively. There was no statistical significance between three groups （P 〉 0.05 ）. Conclusion Both CEUS and postcontrast CT could assess the therapeutic effect of RFA. However,combination of CEUS and CT could improve diagnosis accuracy.