Abstract：ObjectiveTo explore the value of ultrasonic contrast and time-intensity curve (TIC) in radiofrequency ablation (RFA) of hepatic malignancies. MethodsA total of 61 patients (81 lesions) with hematoma malignancies treated in department of ultrasound of Hubei Cancer Hospital from January 2014 to January 2016 were enrolled. According to the random number table method, the patients were randomly divided into the control group (n=31) and the observation group (n=30). Among them, 30 patients (46 lesions) in the observation group were examined by contrast-enhanced ultrasound and the time-intensity curve was calculated, while 31 patients (35 lesions) were conducted by RFA after routine ultrasound examination. The differences of the results of quantitative analysis of normal liver parenchyma and tumor tissue before and after RFA were compared in the observation group. Then the results of contrast-enhanced ultrasonography were compared between residual lesions and normal liver parenchyma after 1 month of RFA treatment. And the differences of RFA therapeutic effect between the observation group and the control group were compared. Kappa consistency test was used to analyze the consistency of contrast-enhanced ultrasound and enhanced CT/MRI results. ResultsPrior to RFA treatment, ultrasound analysis was used to quantify the normal liver parenchyma and peripheral regions of the liver tumor of 46 lesions in the observation group. Preoperative tumor lesions′ IT, PT, and AT ［(13.21±3.47)s，(17.56±7.12)s，(19.02±3.35)s］ were significantly lower than normal liver parenchyma ［(18.75±3.68)s，(31.20±6.13)s，(34.50±3.12)s］, the value of preoperative tumor lesions′ AS (2.89±0.94) was significantly higher than normal liver parenchyma′s (1.28±0.58), the differences between the groups were statistically significant (t=7.43，9.85，22.93，9.89，all P＜0.01). After 1 month of RFA treatment, 67 of the 81 lesions showed no contrast enhancement, 8 lesions showed peripheral high enhancement, 4 lesions showed internal uneven high enhancement, and 2 lesions showed even high enhancement. The TIC analysis showed that the tumor which were completely ablated, the arterial phase, portal phase and delayed phase were free of contrast agent filling. The IT, PT and AT of tumor residual sites ［(15.11±2.57)s，(20.97±3.33)s，(18.32±0.27)s］ were significantly lower than that of normal liver parenchyma ［(19.90±3.96)s，(35.68±2.92)s，(31.28±0.16)s］, the differences between the groups were statistically significant (t=9.13, 29.89, 3717， all P＜0.01). After 3 to 6 months′ follow-up, enhanced CT/MRI were used as control indexs to judge the degree of tumor ablation. After treatment, the complete tumor elimination rate of the observation group was 91.30% (42/46), and the control group was 71.43% (25/35). The therapeutic effect of the observation group was significantly better than that of control group (χ2=5.49, P<0.05). Before RFA, the contrast-enhanced ultrasound and enhanced CT/MRI detection rates were highly consistent (Kappa=0.87, P<0.05). The detection rates of contrast-enhanced ultrasound and enhanced CT/MRI after RFA were highly consistent (Kappa=0.93, P＜0.05). ConclusionsContrast-enhanced ultrasonography and time-intensity curve can effectively identify liver malignant tumor tissue, and have high consistency with enhanced CT/MRI examination. It has high application value in guiding RFA of liver malignant tumor patients, and it is worthy of clinical application.
梅丽丽 聂磊 曾书娥 . 超声造影时间-强度曲线在肝脏恶性肿瘤射频消融中的应用价值[J]. 中华诊断学电子杂志, 2018, 6(4): 226-231.
Mei Lili, Nie Lei, Zeng Shue. Application value of ultrasonic contrast and time-intensity curve in the radiofrequency ablation for the treatment of liver tumors. zhzdx, 2018, 6(4): 226-231.
