声脉冲辐射力成像技术评估肝细胞癌射频消融术后24 h疗效的价值

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摘要目的：探讨声脉冲辐射力成像技术（Acoustic radiation force impulse，ARFI）对评估肝细胞癌（Hepathocellular carcinoma，HCC）射频消融（Radiofrequency ablation，RFA）术后24 h疗效的临床价值。材料与方法：2015年12月—2016年6月我院行RFA治疗22例患者共23个HCC病灶纳入本研究。分别于RFA术前1 d、术后24 h及术后1月行常规超声、超声造影（Contrast enhanced ultrasound，CEUS）及ARFI检查，观察消融灶硬度变化，对比3种方法对消融灶范围的显示情况。结果：23个消融灶RFA术后24 h及术后1月ARFI弹性图均表现为黑暗色（质硬），较术前质硬，边界清晰，范围增大。术后24 h消融灶内部及边缘ARFI弹性值较术前显著升高，差异有统计学意义（P<0.01，P＜0.01），与术后1月比较无统计学差异（P=0.46，P=0.50）；术后24 h及术后1月消融灶周边肝实质ARFI弹性值较术前无统计学差异（P=0.74，P=0.92）。术后24 h及术后1月ARFI与CEUS显示面积的大小比较均无统计学差异（P=0.88，P=0.49），与常规超声比较差异有统计学意义（P<0.01，P＜0.01）。结论：ARFI能够清晰显示RFA术后24 h消融灶范围，与CEUS结果相似，优于常规超声，并能定量反应消融灶硬度变化情况。

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关键词 ：癌, 肝细胞；导管消融术；超声检查, 多普勒, 彩色

Abstract：Objective: To explore the role of acoustic radiation force impulse(ARFI) in assessing the therapeutic response 24 h after radiofrequency ablation(RFA) in hepatocellular carcinoma(HCC). Materials and Methods: A total of 22 patients with 23 HCC lesions who received RFA in our hospital from December 2015 to June 2016 were enrolled. All the patients were examined with base-line ultrasound(BUS), contrast enhanced ultrasound(CEUS) and ARFI one day before RFA, 24 h after RFA and one month after RFA, respectively. The change of ablation area stiffness was measured by virtual touch tissue quantification(VTQ). The ablation lesion area was measured by BUS, virtual touch tissue imaging(VTI) and CEUS. The area of ablation lesions measured by the three methods were compared. Results: Twenty-three tumors showed low-echo on VTI 24 h after RFA and one month after RFA, which were easily detected. The extent of ablation area was enlarged compared to preoperative. After 24 h of RFA procedure, the VTQ value of the internal and marginal ablation lesion area was higher than preoperative(all P<0.01), respectively, but there was no statistically significant difference for one month after RFA(P=0.46, P=0.50). The value of VTQ in peripheral parts of the primary tumor did not change significantly at one week before RFA, 24 h after RFA or one month after RFA(all P>0.05). The ablation lesion areas 24 h after RFA and one month after RFA measured by VTI and CEUS were larger than that by BUS(all P<0.01). However, there was no statistically significant difference of ablation lesion area between VTI and CEUS(P=0.88, P=0.49). Conclusion: ARFI, as a non-invasive, effective and feasible method, can accurately measure the ablation area and provide the change of lesion stiffness immediately after RFA of HCC.

Key words： Carcinoma, hepatocellular Catheter ablation Ultrasonography, Doppler, color

收稿日期: 2016-10-25

PACS:	Ｒ735.7
	Ｒ445.1

基金资助:国家自然科学基金资助项目（编号81060202，81260222）；广西卫生厅重点课题（编号桂卫重2011089）。

通讯作者: 何云，广西医科大学第一附属医院超声科，530021。E-mail：228388072@qq.com

作者简介: 周玲慧（1991-），女，广西宜州人，硕士研究生。E-mail：675652822@qq.com

引用本文:

周玲慧，何云，杨红，卢景宁，彭金波，吴玉泉，李勋泰，甘雨洋，潘登华. 声脉冲辐射力成像技术评估肝细胞癌射频消融术后24 h疗效的价值[J]. 中国临床医学影像杂志, 2017, 28(7): 488-491.
ZHOU Ling-hui, HE Yun, YANG Hong, LU Jing-ning, PENG Jin-bo,. The value of ARFI in assessing the therapeutic response 24 h after RFA in HCC. JOURNAL OF CHINA MEDICAL IMAGING, 2017, 28(7): 488-491.

链接本文:

http://www.jccmi.com.cn/CN/ 或 http://www.jccmi.com.cn/CN/Y2017/V28/I7/488

[1]Harris N, Nadebaum D, Christie M, et al. Acoustic radiation force impulse accuracy and the impact of hepatic steatosis on liver fibrosis staging[J]. J Med Imaging Radiat Oncol, 2016, 60(5): 587-592.（下转503页）
（上接491页）
[2]Xu JM, Xu HX, Zhang YF, et al. Virtual touch tissue imaging for differential diagnosis of thyroid nodules: additional value of the area ratio[J]. J Ultrasound Med, 2016, 35(5): 917-926.
[3]Kim YS, Park JG, Kim BS, et al. Diagnostic value of elastography using acoustic radiation force impulse imaging and strain ratio for breast tumors[J]. J Breast Cancer, 2014, 17(1): 76-82.
[4]Bao Z, Gu L, Liu J, et al. Clinical value of acoustic radiation force impulse elastography in differential diagnosis of focal liver lesions[J]. Zhonghua Gan Zang Bing Za Zhi, 2016, 24(2): 123-126.
[5]中国抗癌协会肝癌专业委员会，中国抗癌协会临床肿瘤学协作委员会，中华医学会肝病学分会肝癌学组. 肝癌射频消融治疗规范的专家共识[J]. 临床肝胆病杂志，2011，27（3）：236-238；244.
[6]Friedrich-Rust M, Romenski O, Meyer G, et al. Acoustic radiation force impulse-imaging for the evaluation of the thyroid gland: a limited patient feasibility study[J]. Ultrasonics, 2012, 52(1): 69-74.
[7]Kudo M, Ueshima K, Kubo S, et al. Response evaluation criteria in cancer of the liver(RECICL)(2015 revised version)[J]. Hepatol Res, 2016, 46(1): 3-9.
[8]Greenbaum LD. Foreword to guidelines and good clinical practice recommendations for contrast enhanced ultrasound(CEUS) in the liver-update 2012[J]. Ultrasound Med Biol, 2013, 39(2): 186.
[9]Liao WJ, Shi M, Chen JZ, et al. Local recurrence of hepatocellular carcinoma after radiofrequency ablation[J]. World J Gastroenterol, 2010, 16(40): 5135-5138.
[10]覃肖溪，杨红，何云，等. 肝癌射频消融治疗后疗效及影响因素分析[J]. 广西医科大学学报，2013，30（4）：587-590.
[11]Doherty JR, Trahey GE, Nightingale KR, et al. Acoustic radiation force elasticity imaging in diagnostic ultrasound[J]. IEEE Trans Ultrasound Ferroelectr Freq Control, 2013, 60(4): 685-701.
[12]D’Onofrio M, Crosara S, De Robertis R, et al. Acoustic radiation force impulse of the liver[J]. World J Gastroenterol, 2013, 19(30): 4841-4849.
[13]Nightingale K, Soo MS, Nightingale R, et al. Acoustic radiation force impulse imaging: in vivo demonstration of clinical feasibility[J]. Ultrasound Med Biol, 2002, 28(2): 227-235.
[14]陈洁鑫，徐晓红，徐辉雄，等. 声脉冲辐射力弹性成像技术评价牛肝组织射频消融的实验研究[J]. 临床超声医学杂志，2013，15（3）：145-148.
[15]陈洁鑫，徐晓红，李明意，等. 声脉冲辐射力弹性成像技术在肝癌射频消融疗效评价中的作用[J]. 广东医学，2015，36（7）：1095-1097.
[16]Correa-Gallego C, Karkar AM, Monette S, et al. Intraoperative ultrasound and tissue elastography measurements do not predict the size of hepatic microwave ablations[J]. Acad Radiol, 2014, 21(1): 72-78.
[17]李巧凤，蒋天安. 声脉冲辐射力成像技术在肝癌射频消融中的初步应用[J]. 中华超声影像学杂志，2015，7（1）：584-588.