动态三维超声造影在肝癌消融疗效评估中的初步研究

目的评价动态三维超声造影（3D-CEUS）在肝癌消融治疗后近期疗效中的诊断价值。方法对75例肝细胞肝癌共89个病灶行超声引导下经皮热消融或化学消融,治疗后1个月行动态3D-CEUS判定局部疗效,以同期对比增强CT（CECT）或对比增强MRI（CEMRI）作为金标准,评估动态3D-CEUS的诊断效能。结果 CECT或CEMRI判定80.9%（72/89）的病灶达到完全消融,19.1%（17/89）的肿瘤消融不全;动态3D-CEUS判定82.0%（73/89）的病灶达到完全消融,18.0%（16/89）的病灶消融不全。与CECT或CEMRI比较,动态3D-CEUS诊断的灵敏度、特异度、阳性预测值、阴性预测值和准确率分别为88.2%（15/17）、98.6%（71/72）、93.8%（15/16）、97.3%（71/73）和96.6%（86/89）。结论动态3D-CEUS在判定肝癌消融局部疗效中,与CECT或CEMRI具有同等的价值。

Application of dynamic three-dimensional contrast-enhanced ultrasonography in assessment of local response to ablation therapy for hepatocellular carcinoma

Objective To evaluate the value of clinical application of dynamic contrast enhanced ultrasound（3D-CEUS） in the assessment of local response to chemical or thermal ablation therapy for hepatocellular carcinoma（HCC）. Methods Thermal or chemical ablation were performed in 75 patients（89 lesions） with HCC. One month after treatment, 3D-CEUS was used to evaluate the local response to ablation therapy. The diagnostic efficacy of 3D-CEUS was evaluated by comparing with contrast-enhanced CT and MRI（CECT/CEMRI） as reference golden standards. Results Complete ablation was diagnosed in lesions of 82.0%（73/89） by 3D-CEUS and 80.9%（72/89） lesions by CECT/CEMRI. And contrast enhancement within lesions was demonstrated in 18.0%（16/89） by 3D-CEUS and 19.1%（17/89） by CECT/CEMRI. As compared to CECT/CEMRI, the sensitivity, specificity, positive predictive value and negative predictive value of 3D-CEUS in diagnosing tumor residue one month after ablation were 88.2%（15/17）, 98.6%（71/72）, 93.8%（15/16） and 97.3%（71/73）, respectively. The diagnostic agreement of 3D-CEUS with CECT/CEMRI was 96.6%（86/89）. Conclusion 3D-CEUS and CECT/CEMRI have identical diagnostic efficacy in assessment of local response to ablation therapy for HCC.