摘要
目的探讨超声造影(CEUS)在微波消融(MVA)治疗大鼠肝泡型包虫病(HAE)术前评估、术中引导及术后疗效评估的应用价值。方法将40只HAE大鼠模型随机分为实验组(n=20只)和对照组(n=20只)。两组术前行常规超声及CEUS测量病灶最大直径。实验组在CEUS引导下行MVA治疗,术后30 min再次行CEUS评估疗效,如有病灶残留,再次消融;对照组在常规超声引导下行MVA治疗。两组术后1月均行CEUS检查,对照病理结果分析,评估病灶完全灭活和残留情况。结果两组共40个HAE病灶,同一切面下,CEUS测得病灶最大直径较常规超声大(实验组t=15.022,对照组t=12.604;P均<0.05);实验组完全消融率高于对照组(χ^(2)=6.144,P=0.031);消融1月后CEUS诊断HAE病灶残留的准确率为87.50%,敏感度为81.81%,特异性为89.66%,与病理诊断结果一致性一般(Kappa=0.695,P<0.05)。结论CEUS成像技术能实时、有效评估大鼠HAE的生物学活性及病灶真实边界,对消融全过程提供有价值的信息。
Objective To explore the value of contrast-enhanced ultrasound(CEUS)in preoperative evaluation,intraoperative guidance and postoperative efficacy evaluation of microwave ablation(MVA)in the treatment of hepatic alveolar echinococcosis(HAE)in rats.Methods Forty HAE rat models were randomly divided into experimental group(n=20)and control group(n=20).The maximum diameter of lesions was measured by conventional ultrasound and CEUS before operation in both groups.The experimental group was treated with MVA under the guidance of CEUS,and the postoperative 30 min was evaluated by CEUS again,and if there were residual lesions,the ablation was performed again,while the control group was treated with MVA under the guidance of conventional ultrasound.CEUS examination was performed in both groups one month after operation,and the complete inactivation and residue of the lesions were evaluated according to the pathological results.Results There were 40 HAE lesions in the two groups,and the maximum diameter of the lesions measured by CEUS was larger than that of conventional ultrasound(experimental group t=15.022,control group t=12.604,P<0.05),and the complete ablation rate of the experimental group was higher than that of the control group(χ^(2)=6.144,P=0.031).One month after ablation,the accuracy of CEUS in diagnosing residual HAE lesions was 87.50%,the sensitivity was 81.81%,and the specificity was 89.66%,which was consistent with the pathological diagnosis(Kappa=0.695,P<0.05).Conclusion CEUS can real-time and effectively detect the biological activity of HAE lesions in rats and the true boundary of lesions,and provide valuable information for the whole ablation process.
作者
沈淼
张玉英
马钦风
王彩霞
SHEN Miao;ZHANG Yuying;MA Qinfeng;WANG Caixia(Department of Ultrasonography, People’s Hospital of Qinghai, Xining 810007, P.R.China)
出处
《医学影像学杂志》
2021年第7期1242-1246,共5页
Journal of Medical Imaging
关键词
超声造影
肝泡型包虫病
微波消融
疗效
超声引导
Contrast-enhanced ultrasound
Hepatic alveolar echinococcosis
Microwave ablation
Efficacy
Ultrasound guidance
