CEUS联合MRI增强扫描早期评价射频消融治疗原发性肝癌患者疗效研究*

doi:10.3969/j.issn.1672-5069.2023.06.032

摘要/Abstract

摘要： 目的研究超声造影(CEUS)联合磁共振成像(MRI)增强扫描早期评价射频消融(RFA)治疗原发性肝癌(PLC)患者疗效的价值。方法 2019年1月～2022年1月我院诊治的PLC患者81例,均接受RFA治疗。,在术后1个月进行CEUS和MRI增强扫描检查,以数字减影血管造影(DSA)检查结果为金标准,评判CEUS或/和MRI增强扫描评价的效能。结果在81例PLC患者中,经DSA检查显示61例患者病灶被完全灭活,20例存在病灶残存;CEUS检查显示病灶被完全灭活的灵敏度、特异度和准确率分别为91.8%、85.0%和90.1%,MRI增强扫描评估的灵敏度、特异度和准确率分别为96.7%、95.0%和96.3%,而两者联合评判的灵敏度、特异度和准确率分别为98.4%、100.0%和98.8%。结论在RFA术后,采用CEUS联合MRI增强扫描检查早期评估RFA治疗PLC患者的效果效能高,临床应用价值高。

关键词: 原发性肝癌, 射频消融, 超声造影, 磁共振成像, 治疗

Abstract: Objective The aim of this study was to investigate the early evaluation of complete inactivation of tumors by contrast enhanced ultrasound (CEUS) and enhanced magnetic resonance imaging (MRI) scan after radiofrequency ablation (RFA) in patients with primary liver cancer (PLC). Methods 81 patients with PLC were encountered in our hospital between January 2019 and January 2022, and all underwent RFA. One month after the treatment, the CEUS and enhanced MRI scan were performed, and the consistency with digital subtraction angiography (DSA), as the gold standard was compared. Results Out of the 81 patients with PLC, the DSA examination showed the tumor foci was completely inactivated in 61 cases, with tumor residual in 20 cases; the sensitivity (Se), specificity (Sp) and accuracy (Ac) by CEUS evaluation were 91.8%, 85.0% and 90.1%, the Se, Sp and Ac by MRI scan were 96.7%, 95.0% and 96.3%, and the Se, Sp and Ac by CEUS and MRI combination evaluation were 98.4%, 100.0% and 98.8%. Conclusion The early evaluation of tumor inactivation by CEUS and enhanced MRI scan combination after RFA treatment in patients with PLC is efficacious, which might guide the clinicians to make appropriate measures for better outcomes.

Key words: Hepatoma, Radiofrequency ablation, Contrast-enhanced ultrasound, Enhanced magnetic resonance imaging, Therapy

刘思宏, 谢琉嘉, 周志明, 许亚春. CEUS联合MRI增强扫描早期评价射频消融治疗原发性肝癌患者疗效研究^*[J]. 实用肝脏病杂志, 2023, 26(6): 895-898.

Liu Sihong, Xie Lujia, Zhou Zhiming, et al. Early evaluation of complete inactivation of tumors by CEUS and enhanced MRI scan after radiofrequency ablation in patients with primary liver cancer[J]. Journal of Practical Hepatology, 2023, 26(6): 895-898.

参考文献

[1] Guo W, Pang Y, Yao L, et al.Imaging fibroblast activation protein in liver cancer: a single-center post hoc retrospective analysis to compare [68ga] ga-fapi-04 pet/ct versus mri and [18f] -fdg pet/ct.Eur J Nucl Med Mol Imaging,2021, 48(5):1604-1617.
[2] Shao L, Wang X, Yu Y, et al.Comparative analysis of the efficacy and accuracy of magnetic resonance imaging (MRI) and contrast-enhanced ct for residual and new lesions after transcatheter arterial chemoembolization (TACE) in patients with primary liver cancer. Transl Cancer Res, 2021, 10(8):3739-3747.
[3] Rennert J, Wiesinger I, Beyer LP, et al.Color coded perfusion analysis and microcirculation imaging with contrast enhanced ultrasound (CEUS) for post-interventional success control following thermal ablative techniques of primary and secondary liver malignancies. Clin Hemorheol Microcirc, 2019, 73(1):73-83.
[4] Lu Q, Zhang XL, Han H, et al.Value of perfusion parameters for differentiating hepatocellular carcinoma and liver metastasis with hypervascularity and a normal hepatic background on contrast-enhanced ultrasound imaging. J Ultrasound Med, 2019, 38(10):2601-2608.
[5] Kim D, Lee JH, Moon H, et al.Development and evaluation of an ultrasound-triggered microbubble combined transarterial chemoembolization (TACE) formulation on rabbit vx2 liver cancer model. Theranostics, 2021, 11(1):79-92.
[6] 高军喜,谷昊,王雅婷,等.经皮局麻联合超声造影对困难肝癌RFA治疗的可行性及安全性分析.中华普通外科杂志,2019, 34(7):572-575.
[7] 中国抗癌协会肝癌专业委员会,中华医学会肝病学分会肝癌学组,中国抗癌协会病理专业委员会,中华医学会病理学分会消化病学组,中华医学会外科学分会肝脏外科学组,中国抗癌协会临床肿瘤学协作专业委员会,全国肝胆肿瘤及移植病理协作组.原发性肝癌规范化病理诊断指南(2015年版).中华肝脏病杂志,2015, 23(5):321-327.
[8] Choi SH, Jeon SK, Lee SS, et al.Radio-pathologic correlation of biphenotypic primary liver cancer (combined hepatocellular cholangiocarcinoma): changes in the 2019 who classification and impact on li-rads classification at liver MRI. Eur Radiol, 2021, 31(12):9479-9488.
[9] Yamada A, Oyama K, Fujita S, et al.Dynamic contrast-enhanced computed tomography diagnosis of primary liver cancers using transfer learning of pretrained convolutional neural networks: is registration of multiphasic images necessary. Int J Comput Assist Radiol Surg, 2019, 14(8):1295-1301.
[10] Bröker MEE, Taimr P, Vries Md, et al.Performance of contrast-enhanced sonography versus mri with a liver-specific contrast agent for diagnosis of hepatocellular adenoma and focal nodular hyperplasia. AJR, 2020, 214(1):81-89.
[11] Luz JHM, Gomes FV, Costa NV, et al.Bestflr trial: liver regeneration at CT before major hepatectomies for liver cancer-a randomized controlled trial comparing portal vein embolization withn-butyl-cyanoacrylate plus iodized oil versus polyvinyl alcohol particles plus coils. Radiology, 2021, 299(3):715-724.
[12] Hirooka M, Koizumi Y, Tanaka T, et al.Efficacy of combining electric-field and coronal-plane imaging to obtain ultrasound-ultrasound fusion images in monopolar radiofrequency ablation for patients with liver cancer. Hepatol Res, 2020, 50(8):985-995.
[13] Jin H, Chalkidou A, Hawkins M, et al.Cost-effectiveness analysis of stereotactic ablative body radiation therapy compared with surgery and radiofrequency ablation in two patient cohorts: metastatic liver cancer and hepatocellular carcinoma. Clin Oncol, 2021, 33(3):143-154.
[14] Yu C, Wu S, Zhao J, et al.Evaluation of efficacy, safety and treatment-related outcomes of percutaneous radiofrequency ablation versus partial hepatectomy for small primary liver cancer meeting the milan criteria: a systematic review and meta-analysis of randomized controlled trials. Clin Res Hepatol Gastroenterol, 2020, 44(5):718-732.
[15] Guo C, Liang H, Yuan W, et al.Analysis on the value of soluble intercellular adhesion molecule-1 (sicam-1), alpha fetoprotein (AFP), and aspartate aminotransferase/platelet ratio index (apri) in predicting the prognostic survival of patients with primary liver cancer after radiofrequency ablation. Ann Palliat Med, 2021, 10(4):4760-4767.
[16] Yamashita YI, Imai K, Kaida T, et al.Multimodal radiofrequency ablation versus laparoscopic hepatic resection for the treatment of primary hepatocellular carcinoma within milan criteria in severely cirrhotic patients: long-term favorable outcomes over 10 years Surg Endosc, 2019, 33(1):46-51.
[17] Lee S, Kim KW, Jeong WK, et al.Liver imaging reporting and data system category on magnetic resonance imaging predicts recurrence of hepatocellular carcinoma after liver transplantation within the milan criteria: a multicenter study. Ann Surg Oncol, 2021, 28(11):6782-6789.
[18] 汪玲,陆英慧,王天佑.靶向血管内皮生长因子受体2的超声造影对裸鼠肝癌皮下移植瘤模型中抗血管生成治疗反应的无创监测价值.中华肿瘤杂志,2020, 42(10):856-860.
[19] Koh DM, Ba-Ssalamah A, Brancatelli G, et al.Consensus report from the 9th international forum for liver magnetic resonance imaging: applications of gadoxetic acid-enhanced imaging. Eur Radiol, 2021, 31(8):5615-5628.
[20] 叶辰,任思谦,阿卜杜海拜尔·萨杜拉,等.钆塞酸二钠MRI增强在肝癌大块肝切除手术中的应用价值.中华外科杂志,2020, 58(10):765-769.

CEUS联合MRI增强扫描早期评价射频消融治疗原发性肝癌患者疗效研究^*

Early evaluation of complete inactivation of tumors by CEUS and enhanced MRI scan after radiofrequency ablation in patients with primary liver cancer

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价

[1]	杨蕊旭, 齐明华. 慢性HBV感染合并代谢相关性脂肪性肝病患者抗病毒治疗对策^*[J]. 实用肝脏病杂志, 2023, 26(6): 773-776.
[2]	宋涛, 徐敏, 党子龙, 孙珺珺. 恩替卡韦联合α-干扰素治疗慢性乙型肝炎患者疗效研究^*[J]. 实用肝脏病杂志, 2023, 26(6): 785-788.
[3]	高丽娟, 李永库, 董新颖, 杨艺宁, 冷雪君. 艾米替诺福韦治疗慢性乙型肝炎患者疗效初步研究^*[J]. 实用肝脏病杂志, 2023, 26(6): 789-792.
[4]	周季颖, 谢月红, 于翠霞. 恩替卡韦治疗慢性乙型肝炎合并非酒精性脂肪性肝病患者疗效研究^*[J]. 实用肝脏病杂志, 2023, 26(6): 793-796.
[5]	曹汴川, 刘梅, 丁苹, 汤玲毓, 郭明贤, 周仙, 袁天茹, 严一凯, 黄富礼, 黄永茂. 格卡瑞韦/哌仑他韦治疗HCV感染者和人类免疫缺陷病毒合并HCV感染者疗效及安全性研究^*[J]. 实用肝脏病杂志, 2023, 26(6): 801-804.
[6]	王卓雅, 吴洋鹏, 黄益桃. 还原型谷胱甘肽联合护肝清脂片治疗非酒精性脂肪性肝病患者疗效研究^*[J]. 实用肝脏病杂志, 2023, 26(6): 823-826.
[7]	陈雅君, 朱婧, 李璐, 何钦. 标准免疫抑制疗法联合异甘草酸镁治疗自身免疫性肝炎患者外周血B细胞和调节性B细胞变化^*[J]. 实用肝脏病杂志, 2023, 26(6): 835-838.
[8]	杨开宁, 王梦梦, 王占坤, 陈秀秀, 肖剑, 王永丽. 注射用谷胱甘肽联合硫普罗宁治疗药物性肝损伤患者疗效研究^*[J]. 实用肝脏病杂志, 2023, 26(6): 839-842.
[9]	王新月, 周莉, 董金玲, 陈煜. 双重血浆分子吸附系统治疗肝衰竭患者应用甲磺酸萘莫司他与肝素抗凝有效性与安全性比较研究^*[J]. 实用肝脏病杂志, 2023, 26(6): 843-846.
[10]	姜亚超, 尹力, 颜状. “改良三明治夹心法”行ESVD术治疗肝硬化并发食管胃静脉曲张患者疗效研究^*[J]. 实用肝脏病杂志, 2023, 26(6): 863-866.
[11]	刘公攀, 陈涛, 丁志刚, 任明, 郭兴军, 邵存华, 卢建树. CalliSpheres可载药微球经导管肝动脉化疗栓塞序贯射频消融治疗原发性肝癌患者疗效研究^*[J]. 实用肝脏病杂志, 2023, 26(6): 879-882.
[12]	莫春明, 黄德佳, 韦惠章, 罗江伟. TACE术治疗的原发性肝癌患者血清IL-33水平变化及其对发热的鉴别意义探讨^*[J]. 实用肝脏病杂志, 2023, 26(6): 887-890.
[13]	于双杰, 李元元, 毕京峰, 福军亮, 宓余强. ICIs联合TKIs治疗HBV相关肝细胞癌患者疗效研究^*[J]. 实用肝脏病杂志, 2023, 26(6): 891-894.
[14]	楼鹏, 邓继红, 严铭一. 腹腔镜肝切除术治疗原发性肝癌患者应用右美托咪定复合布托啡诺术后镇痛效果研究^*[J]. 实用肝脏病杂志, 2023, 26(6): 899-902.
[15]	周莉, 丁云清, 袁凤英, 陈竹, 冯志伟. 超声造影判断乙型肝炎肝硬化患者肝内占位性病变性质价值研究^*[J]. 实用肝脏病杂志, 2023, 26(6): 903-906.