超声造影和增强CT评价肝癌射频消融术后复发和新生肿瘤的一致性分析

Consistent analysis of contrast-enhanced ultrasound and enhanced CT evaluation of recurrence and neoplasms after radiofrequency ablation of liver caner

目的探讨肝脏恶性肿瘤射频消融术后,超声造影(contrast-enhanced ultrasound,CEUS)与增强CT(contrast-enhanced computed tomography,CECT)对其疗效评估的一致性。方法回顾性分析新疆医科大学第一附属医院76例经射频消融治疗的肝癌患者临床资料,对比分析术后CEUS及CECT检查在对射频消融区疗效评估及发现新生肿瘤的一致性。结果常规超声检查显示,77.6%的病灶呈不均质回声,17.1%呈高回声,5.3%呈低回声;CT平扫显示,88.2%的病灶呈低密度影,6.6%呈高密度影,5.2%呈混杂密度影;超声造影显示,28.94%病灶增强,呈高增强,其中提示复发8例,新生肿瘤12例;增强CT显示,25%病灶强化,其中提示复发7例,新生肿瘤12例。CEUS与CECT评价肝脏背景的一致性一般,评价消融范围的一致性较差,评价病灶位置和局部复发的一致性很好,评价病灶数量、术区残留、发现新生肿瘤及诊断方面的一致性较好。结论超声造影与增强CT均能作为肝脏恶性肿瘤射频消融术后评价的方法,两者联合评估准确性会更高。

Objective To evaluate the consistency of contrast-enhanced ultrasound(CEUS)and contrast-enhanced CT(CECT)in the efficacy of radiofrequency ablation(RFA)of hepatic malignant tumors.Methods The clinical data of 76 patients with liver cancer treated by radiofrequency ablation in the First Affiliated Hospital of Xinjiang Medical University were analyzed retrospectively.The consistency of CEUS and CECT in evaluating the efficacy of radiofrequency ablation and new tumors were compared and analyzed.Results Conventional ultrasound showed that heterogeneous echo accounted for 77.6%of the lesions,hyperechoic accounted for 17.1%,and hypoechoic accounted for 5.3%;plain CT scan showed that low density accounted for 88.2%of the lesions,high density accounted for 6.6%,and mixed density accounted for 5.2%;CEUS showed that 28.94%of the lesions were enhanced highly,including 8 cases of recurrence and 12 cases of new tumor;CECT showed that 25%of the lesions were enhanced,including 7 cases of recurrence and 12 cases of new tumor.The consistency of the evaluation of liver background was general,the consistency of the ablation scope was poor,the consistency of lesion location and local recurrence were very good,and the number of lesions,residual surgical area,discovery of neoplasia and diagnosis were good also.Conclusion Both CEUS and enhanced CECT can be used as methods for postoperative evaluation of liver malignant tumors after radiofrequency ablation,and the accuracy of combined evaluation will be higher.