超声造影对肝癌消融术疗效的评估价值分析

Value Analysis of Contrast-enhanced Ultrasound in Evaluating the Efficacy of Liver Cancer Ablation Surgery

目的 探讨超声造影对肝癌热消融术后疗效的评估价值。方法 收集肝癌患者200例,共256枚病灶,所有患者均行肝癌热消融术,分别采用超声造影与增强CT或MRI检查肿瘤情况。统计术后完全消融率,以增强CT或MRI检查为标准,分析超声造影的准确率、灵敏度、特异度,比较超声造影与增强CT或MRI评估热消融疗效的差异。结果 消融治疗后1个月,经增强CT或MRI检查256枚肝癌病灶中有234枚病灶完全消融,22枚病灶残留,完全消融率为91.41%(234/256);超声造影显示230枚病灶完全消融,26枚病灶残留,两种方法检查结果比较无差异(P>0.05);对256枚病灶进行术后疗效评估,增强CT或MRI显示的234枚消融病灶超声造影显示其中227枚病灶完全消融,7枚病灶残留;增强CT或MRI显示的22枚残留病灶超声造影显示其中3枚病灶完全消融,19枚病灶残留,两种方法检查结果比较无差异(P>0.05);以增强CT或MRI检查为标准,超声造影评估肝癌患者热消融术后的疗效准确率为96.09%,灵敏度为86.36%,特异度为97.01%。结论 超声造影能够准确评估肝癌患者消融术后的消融疗效,评估效果与增强CT或MRI一致,可作为肝癌患者随访中的一种有效检查方法。

Objective To explore the value of contrast-enhanced ultrasound in evaluating the curative effect of liver cancer after thermal ablation.Methods A total of 256 lesions were collected from 200 patients with liver cancer.All patients underwent thermal ablation of liver cancer,and the tumor was examined by contrast-enhanced ultrasound and enhanced CT or MRI respectively.The complete ablation rate after operation was counted,and the accuracy,sensitivity and specificity of contrast-enhanced ultrasound were analyzed based on enhanced CT or MRI,and the differences between contrast-enhanced ultrasound and enhanced CT or MRI in evaluating thermal ablation efficacy were compared.Results One month after ablation treatment,234 of 256 liver cancer lesions were completely ablated and 22 lesions remained after enhanced CT or MRI examination,with a complete ablation rate of 91.41%(234/256).Contrast-enhanced ultrasound showed that 230 lesions were completely ablated and 26 lesions remained.There was no difference between the two methods(P>0.05).The postoperative efficacy of 256 lesions was evaluated.Contrast-enhanced ultrasound showed that 227 lesions were completely ablated and 7 lesions remained among 234 ablation lesions displayed by enhanced CT or MRI.Contrast-enhanced ultrasound of 22 residual lesions revealed by enhanced CT or MRI showed that 3 lesions were completely ablated and 19 lesions remained.There was no difference between the 2 methods(P>0.05).Based on enhanced CT or MRI,the accuracy,sensitivity and specificity of contrast-enhanced ultrasound in evaluating the curative effect of patients with liver cancer after thermal ablation are 96.09%,86.36%and 97.01%.Conclusion Contrast enhanced ultrasound can accurately evaluate the ablation efficacy of patients with liver cancer after ablation,and the evaluation results are consistent with enhanced CT or MRI.It can be used as an effective examination method for follow-up of patients with liver cancer.