CEUS联合MRI实时导航技术对小肝癌检出价值的研究

Value of CEUS combined with MRI real-time navigation technology in the detection of small liver cancer

目的:探讨超声造影(contrast-enhanced ultrasound,CEUS)联合磁共振成像(magnetic resonance imaging,MRI)实时导航(real-time navigation)技术对小肝癌检出价值的研究。方法:回顾并分析临床疑诊为小肝癌的31例患者共40个肝内病灶的超声图像,在行实时导航检查前增强MRI均提示肝内有增强灶,且单一病灶最大径均≤20 mm。比较常规超声和实时导航在小肝癌检出率上的差异,分析影响实时导航检出率的因素。结果:40个肝内病灶中9个经手术后或穿刺病理学检查确诊,31个经临床综合诊断确诊。均行CEUS联合MRI实时导航检查,融合成功率100.0%。常规超声肝内病灶检出率为32.5%(13/40),实时导航检出率为92.5%(37/40),两者间在检出率方面差异有统计学意义(P<0.05)。在不同大小的小肝癌病灶组,实时导航的检出率分别为88.9%(16/18,6~10 mm)、100%(16/16,11~15 mm)及83.3%(5/6,16~20 mm),实时导航在不同大小的肝内病灶检出率上差异无统计学意义(P=0.359)。在不同肝叶的小肝癌病灶组,实时导航检出率分别为尾状叶100.0%(2/2),左外叶100.0%(7/7),左内叶100.0%(8/8),右前叶81.8%(9/11),右后叶91.7%(11/12),实时导航在不同肝叶的肝内病灶检出率上差异无统计学意义(P=0.658)。在不同回声类型的小肝癌病灶组,实时导航检出率分别为88.9%(24/27,等回声)及100.0%(13/13,稍低及低回声),实时导航在不同回声类型的肝内病灶检出率上差异无统计学意义(P=0.538)。结论:CEUS联合MRI实时导航技术有助于提高小肝癌的检出率。

Objective:To investigate the value of contrast-enhanced ultrasound(CEUS)combined with magnetic resonance imaging(MRI)real-time navigation technology in the detection of small liver cancer.Methods:The ultrasonic images of 40 intrahepatic lesions in 31 patients with clinically suspected small liver cancer were analyzed retrospectively.Before real-time navigation,enhanced MRI showed that there were enhanced lesions in the liver,and the maximum diameter of a single lesion was≤20 mm.To compare the difference between conventional ultrasound and real-time navigation in the detection rate of small liver cancer,and analyze the factors affecting the detection rate of real-time navigation.Results:Among the 40 intrahepatic lesions,9 lesions were confirmed by surgery or biopsy,and 31 lesions were confirmed by comprehensive clinical diagnosis.All patients underwent CEUS combined with MRI real-time navigation examination,and the fusion success rate was 100.0%.The detection rate of intrahepatic lesions by conventional ultrasound was 32.5%(13/40)and that by real-time navigation was 92.5%(37/40),and the difference in detection rate between the two was statistically significant(P<0.05).In the groups of small liver cancer lesions of different sizes,the detection rates of real-time navigation were 88.9%(16/18,6-10 mm),100.0%(16/16,11-15 mm)and 83.3%(5/6,16-20 mm),respectively,and the detection rates of intrahepatic lesions of different sizes by real-time navigation were not statistically significant(P=0.359).In the groups of small liver cancer lesions in different liver lobes,the detection rates of real-time navigation were 100.0%(2/2)in the caudate lobe,100.0%(7/7)in the left lateral lobe,100.0%(8/8)in the left medial lobe,81.8%(9/11)in the right anterior lobe and 91.7%(11/12)in the right posterior lobe,respectively,and there was no statistical significance in the detection rate of intrahepatic lesions in different liver lobes by real-time navigation(P=0.658).In the groups of small liver cancer lesions with different echo types,the detection rates of real-time navigation were 88.9%(24/27,iso-echoic)and 100.0%(13/13,slightly lower echo and hypo-echoic),respectively,and there was no statistically significant difference in the detection rate of intrahepatic lesions of different echo types by real-time navigation(P=0.538).Conclusion:CEUS combined with MRI real-time navigation technology helps to improve the detection rate of small liver cancer.