术中超声造影评价肝射频消融效果的实验研究

摘要

Objective To discuss the use of contrast enhanced intraoperative uhrasound(CE-IOUS) in evaluating hepatic radiofrequency ablation(RFA)lesions.Methods Fifteen RFA lesions in twelve dogs were examined by IOUS and CE-IOUS 15 min and 30 min after RFA.IOUS and CE-IOUS images were compared with RFA specimen stained by TTC.Results Satisfactory images could be achieved bv CE-IOUS at 15 rain after RFA.Compared with IOUS,CE IOUS could depict the border of RFA lesions more clearly (P＜0.01).In CE-IOUS,93.3%(12/13)of RFA lesion images were consistent with that of TTC in shape,while in IOUS,only 13.3%(2/15)of the images were consistent with that of TTC in shape.The average areas of RFA lesions cross-section measured by IOUS,CE-IOUS and TTC were(4.82±1.49)cm2,(3.48±1.25)cm2 and(2.93±0.87)cm2.Statistical significance was found between the areas shown by IOUS and TTC staining(P=0.000),as well as between CE-IOUS and TTC staining(P=0.027).The areas shown by IOUS and TTC were not linear correlated(r=0.28,P=0.316),but the areas shown bv CE IOUS and TTC were wetl correlated(r=0.75,P=0.002). Conclusions CE-IOUS is a promising method for evaluating intraoperative RFA lesions and worthy of further clinical research.%目的 探讨术中超声造影(contrast enhanced intraoperative uhrasound,CE-IOUS)评价肝射频消融(radio frequency ablation,RFA)的价值.方法 12条狗共15个消融灶于RFA后15 min及30 min行术中超声(intraoperatiVe ultrasound,IOUS)和CE-IOUS扫查,评价显示效果,并与大体标本对比.结果 RFA结束15 min后行CE-IOUS可获得满意图像;与IOUS相比,CE-IOUS能更清楚地显示消融灶的边界(P=0.000),且CE-IOUS所示消融灶形态与大体标本一致性好;IOUS、CE-IOUS和大体标本显示坏死灶面积分别为(4.82±1.49)cm2、(3.48±1.25)cm2及(2.93±0.87)cm2,IOUS和CE-IOUS与太体标本显示面积差别均有统计学意义(P=0.000),但前者与大体标本间无线性相关(r=0.28,P=0.316),后者与大体标本相关性良好(r=0.75,P=0.002).结论 CE-IOUS能在一定程度上准确评价RFA效果,值得进一步临床研究.