US-CT/MRI融合成像在超声引导射频消融显影困难的肝癌患者中的应用价值

Application Value of US-CT/MRI Fusion Imaging in Liver Cancer Patients withDifficulty in Ultrasound-guided Radiofrequency Ablation Imaging

目的探讨超声-CT/磁共振成像(US-CT/MRI)融合成像在超声引导射频消融显影困难的肝癌患者中的应用价值。方法选取行超声引导下射频消融治疗的肝癌患者84例(104个病灶),根据常规超声下显影难度分为显影困难组与显影清晰组,显影困难组共31例(37个病灶),显影清晰组共53例(67个病灶)。显影困难组在US-CT/MRI融合成像下行射频消融治疗,显影清晰组行常规超声引导下射频消融治疗,观察射频消融治疗结果及围术期并发症发生情况。结果显影清晰组患者均行完成射频消融治疗;显影困难组有2例单个病灶患者未能图像融合成功,实际35个病灶US-CT/MIR图像融合成功,图像对位时间为3.7~17 min,平均(6.19±1.98)min,行射频消融治疗。显影清晰组实际完成的射频消融率、术后完全消融率分别为100.00%(67/67)、97.01%(65/67),显影困难组分别为94.59%(35/37)、100.00%(35/35),比较差异无统计学意义(P>0.05)。显影清晰组术中补充消融率为7.46%(5/67),显影困难组为23.53%(8/35),比较差异有统计学意义(P<0.05)。2组患者实施射频消融治疗时均未发生大出血等并发症。结论常规超声引导射频消融显影困难的肝癌患者病灶通过US-CT/MRI融合成像能清晰显影,对位好,完全消融率和安全性高,具有较高的临床应用价值。

Objective To discuss the application value of US-CT/MRI fusion imaging in liver cancer patients with difficulty in ultrasound-guided radiofrequency ablation imaging.Methods We collected ultrasound-guided radiofrequency ablation 85 cases(104 lesions)of patients with liver cancer,the degree of development under conventional ultrasound was divided into the difficult group and the clear group,there were 31 cases(37 lesions)in the difficult group and 53 cases(67 lesions)in the clear group,the difficult group underwent radiofrequency ablation after US-CT/MRI fusion imaging,conventional ultrasound-guided radiofrequency ablation was performed in the clear group,to observed the results of radiofrequency ablation and perioperative complications.Results The clear group was radiofrequency ablation,image fusion was not successful in 2 lesions with single lesion in the difficulty group,US-CT/MIR image fusion of 35 lesions was successful,the image positioning time was 3.7~17(6.19±1.98)min,radiofrequency ablation was performed.The actual radiofrequency ablation rate and postoperative complete ablation rate were 100.00%(67/67)and 97.01%(65/67)in the clear group,94.59%(35/37)、100.00%(35/35)in the difficult group,there was no statistically significant difference(P>0.05).The intraoperative supplementary ablation rate was 7.46%(5/67)in the clear group,23.53%(8/35)in the difficult group,the difference was statistically significant(P<0.05).The two groups of patients underwent radiofrequency ablation without massive bleeding and other complications.Conclusion The application value of US-CT/MRI fusion imaging in ultrasound-guided radiofrequency ablation imaging is difficult of patients with liver cancer,the image is clear and the alignment is accurate,the postoperative complete ablation rate and safety are high,it has high clinical application value.