高军喜, 王颖鑫, 杨磊, 姚兰辉. 超声造影与增强CT对肝癌射频消融效果的一致性评价[J]. 中国肿瘤临床, 2013, 40(19): 1179-1183. DOI: 10.3969/j.issn.1000-8179.20130173
引用本文: 高军喜, 王颖鑫, 杨磊, 姚兰辉. 超声造影与增强CT对肝癌射频消融效果的一致性评价[J]. 中国肿瘤临床, 2013, 40(19): 1179-1183. DOI: 10.3969/j.issn.1000-8179.20130173
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Junxi GAO, Yingxin WANG, Lei YANG, Lanhui YAO. Evaluation of the consistency between contrast-enhanced ultrasound and enhanced CT in determining the effect of radiofrequency ablation on hepatocellular carcinoma[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2013, 40(19): 1179-1183. DOI: 10.3969/j.issn.1000-8179.20130173
Citation: Junxi GAO, Yingxin WANG, Lei YANG, Lanhui YAO. Evaluation of the consistency between contrast-enhanced ultrasound and enhanced CT in determining the effect of radiofrequency ablation on hepatocellular carcinoma[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2013, 40(19): 1179-1183. DOI: 10.3969/j.issn.1000-8179.20130173
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超声造影与增强CT对肝癌射频消融效果的一致性评价

Evaluation of the consistency between contrast-enhanced ultrasound and enhanced CT in determining the effect of radiofrequency ablation on hepatocellular carcinoma

    摘要
  • 摘要:
      目的  对超声造影与增强CT对肝癌射频消融术后评价效果一致性进行分析。
      方法  对35例患者共68个肿瘤病灶进行超声或CT引导下射频消融治疗，术后同时定期进行增强CT以及超声造影检查评价射频消融效果，分析超声造影以及增强CT在肿瘤完全消融率、残留率，复发率、准确性以及超声造影与增强CT一致性。
      结果  68个病灶中，超声造影评价肿瘤总体完全消融率以及残留率分别为84%及16%，增强CT分别为90%及10%，二者之间比较差异无统计学意义(χ2=0.576 3，P=0.447 8)，具有很高的一致性(K=0.882 9，Sk=0.120 4)，68个病灶中24个月内共有13个病灶为复发病灶，超声造影对复发病灶检出率为92%(12/ 13)，与增强CT 100%(13/13)之间比较差异无统计意义(P>0.05)。以增强CT作为判断RFA后肿瘤残留及复发的金标准，超声造影对68个肿瘤病灶总体诊断准确性为92%(63/68)，5个病灶判断不一致。
      结论  超声造影在肝癌射频消融效果评价中与增强CT具有很高准确性及一致性，能为肿瘤射频消融术后治疗提供可靠诊断依据。

     

    Abstract:
      Objective  This study aims to evaluate the consistency between contrast-enhanced ultrasound (CEUS) and enhanced computed tomography (CT) in determining the effect of radiofrequency ablation (RFA) on hepatocellular carcinoma.
      Methods  RFA procedures guided by either ultrasound or CT were performed on 35 patients with 68 lesions. Enhanced CT and CEUS were regularly conducted after the procedures to evaluate the effect of RFA. The full ablation, residual, and recurrence rates of tumors, as well as the diagnostic accuracies and kappa values of CEUS and enhanced CT, were determined.
      Results  The full ablation and residual rates of tumors for the 68 lesions diagnosed by CEUS were 84% and 16%, respectively; whereas those for the lesions diagnosed by enhanced CT were 90% and 10%, respectively. No significant difference was found between the obtained rates using the two diagnostic methods (χ2=0.576 3, P=0.447 8). Moreover, the two methods exhibited high consistency (K=0.882 9, Sk=0.120 4). Of the 68 lesions, 13 recurred within 24 months. The recurrence rate evaluated by CEUS was 19% (13/68). No significant difference was found between the detection rates of CEUS (92%, 12/ 13 lesions) and enhanced CT (100%, 13/13 lesions) in diagnosing recurrent lesions (P>0.05). Enhanced CT could be used as the gold standard for evaluating tumor residual and recurrence rates after RFA. The overall diagnostic accuracy of CEUS reached 92% (63/68 lesions).
      Conclusion  CEUS and enhanced CT exhibit high accuracy and consistency in evaluating the effect of RFA on hepatocellular carcinoma. CEUS can provide a reliable diagnostic proof for tumor patients after undergoing RFA procedure.

     

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