常规超声与超声造影实时判断活体猪肝射频消融效果的价值比较

发布时间：2018-03-21 20:11

本文选题：肝脏　切入点：射频消融　出处：《山东医药》2017年10期 　论文类型：期刊论文

【摘要】：目的对比分析常规超声和超声造影实时判断活体猪肝射频消融(RFA)效果的价值。方法对10只小型活体猪肝进行RFA,术后即刻行常规超声和超声造影检查,处死后切取消融灶行病理检查;比较三种检查方法测得的消融灶范围,以组织切片病理检查结果为标准分析超声造影判断消融灶是否完全消融的价值。结果 10只活体猪肝共产生43个消融灶,常规超声所测消融灶左右径、垂直径及所计算出的面积均小于大体标本(P均㩳0.05),二者各指标均相关(r分别为0.977、0.943、0.956,P均㩳0.05);超声造影所测消融灶左右径、垂直径及所计算出的面积均与大体标本差异无统计学意义(P均0.05),二者各指标均相关(r分别为0.949、0.958、0.919,P均㩳0.05)。组织切片病理检查判断30个消融灶不完全消融、13个完全消融,超声造影判断28个消融灶不完全消融、15个完全消融。超声造影判断消融灶的准确率为81.4%、灵敏性为83.3%、特异性为76.9%、阳性预测值为89.3%、阴性预测值为66.7%、漏诊率为16.7%、阳性似然比为3.61、阴性似然比0.22,与组织切片病理检查判断消融灶是否完全消融的结果相一致(P=0.727)。结论在RFA术后常规超声实时判断活体猪肝射频消融灶范围的价值有限,超声造影能够为RFA术后实时判断活体猪肝射频消融灶范围及是否完全消融提供可靠的影像学判断依据。
[Abstract]:Objective to compare and analyze the value of conventional ultrasound and contrast-enhanced ultrasound in evaluating the effect of radiofrequency ablation (RFA) of live pig liver. Methods 10 small live pig liver were treated with RFA.Contrast-enhanced ultrasound and contrast-enhanced ultrasonography were performed immediately after operation. After death, the ablation focus was removed for pathological examination, and the range of ablation foci measured by the three methods was compared. Results there were 43 ablation foci in 10 pig livers, and the diameter of ablation focus was measured by conventional ultrasound. The vertical diameter and the calculated area are smaller than that of the gross specimen. The correlation r between the two indexes was 0.947 ~ 0.943 ~ 0.956 (P = 0. 05), P < 0. 05, P = 0. 977, 0. 943, 0. 956, respectively. The diameter, vertical diameter and calculated area of ablation focus measured by contrast-enhanced ultrasound were not significantly different from those of gross specimen (P < 0.05). Histopathological examination showed that 30 ablation foci were incomplete, 13 were completely ablated. The accuracy, sensitivity, specificity, positive predictive value, negative predictive value, missed diagnosis rate and false diagnosis rate were 81.4, 83.3, 76.9, 89.3, 66.7, 16.7and 16.7respectively, respectively, in contrast to 28 ablation foci and 15 complete ablation foci by contrast-enhanced ultrasonography. The accuracy of ultrasound was 81.4, the sensitivity was 83.3, the specificity was 76.9, the positive predictive value was 89.3, the negative predictive value was 66.7, the missed diagnosis rate was 16.7. The ratio of RIA was 3.61, and the negative likelihood ratio was 0.22, which was consistent with the results of pathological examination of histopathology in judging whether or not the ablation focus was completely ablated. Conclusion conventional ultrasound is of limited value in judging the extent of radiofrequency ablation of live pig liver after RFA. Contrast-enhanced ultrasound can provide a reliable imaging basis for judging the range of radiofrequency ablation in living pig liver and complete ablation after RFA.
【作者单位】：贵州医科大学附属人民医院;
【基金】：贵州省科技厅联合基金资助项目(黔科合LH字2014-7016号)
【分类号】：R445.1;R735.7

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