| 实时超声造影在活体猪肝多次射频消融中应用价值的实验研究 |
| 投稿时间：2017-01-06 修订日期：2017-01-23 点此下载全文 |
| 引用本文：黄磊,黄建钊,刘江伟,孙海英,赵鹏伟,柳严,孙倩.实时超声造影在活体猪肝多次射频消融中应用价值的实验研究[J].医学研究杂志,2017,46(10):108-112 |
| DOI：
10.11969/j.issn.1673-548X.2017.10.028 |
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| 基金项目:贵州省科技厅联合基金资助项目（黔科合LH字[2014]7016号） |
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| 中文摘要:目的 探究实时超声造影（contrast-enhanced ultrasound，CEUS）在活体猪肝多次射频消融（radiofrequency Ablation，RFA）中的应用价值。方法 首先建立活体猪肝不完全消融灶模型，然后由实时CEUS指导二次RFA，并且RFA术后予实时CEUS评估消融效果。另外在活体猪肝不完全消融灶模型的基础上由实时CEUS指导RFA，RFA术后予实时CEUS评估消融效果，并将消融灶分为完全消融组和不完全消融组，将不完全消融组中的半数消融灶在实时CEUS指导下补充RFA直至实时CEUS判断为完全消融。实验结束后对消融灶行病理检查，最后将CEUS检查结果与病理检查结果相比较。结果 本实验用7只活体猪肝共产生二次射频消融灶31个，实时CEUS评估有10个不完全消融，21个完全消融，病理检查示9个不完全消融，22个完全消融。实时CEUS指导二次RFA的完全消融率为71%，不完全消融率为29%。实时CEUS判断消融灶残留的准确性为83.9%，敏感度77.8%，特异性86.3%，并且CEUS与病理检查判断消融灶是否完全消融结果的McNemar检验P>0.05，差异无统计学意义，表明两种判断结果是相一致的。另外3只活体猪肝多次射频消融实验中，证实CEUS判断无残留的消融灶病理检查也证实真的无残留，而有残留的消融灶内病理检查时也发现有正常肝细胞的残留。结论 实时CEUS能准确的指导活体猪肝进行多次RFA，并且能为活体猪肝的多次RFA疗效评估提供可靠的影像学依据。 |
| 中文关键词:肝脏 射频消融 超声造影 动物实验 |
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| Experimental Study of Contrast-enhanced Ultrasound in Porcine Liver Multiple Radiofrequency Ablation Application Value |
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| Abstract:Objective To explore the application value of Real time Contrast-enhanced ultrasound(contrast-enhanced ultrasound, CEUS)in porcine liver Multiple radiofrequency ablation (radiofrequency Ablation,RFA). Methods Firstly, building incomplete ablation model in porcine liver, and then the twice RFA was guided by real-time CEUS, and the ablation effect was evaluated by real-time CEUS after RFA. In addition, RFA was guided by real-time CEUS on the basis of the incomplete ablation model of live pig liver. The effect of ablation was evaluated by real-time CEUS after RFA, and the ablation foci was divided into complete ablation group and incomplete ablation group, under the guidance of real-time CEUS, half of the ablation sites in the incomplete ablation group were supplemented with RFA until it was judged as completely ablated by real-time CEUS. At the end of the experiment, pathological examination was performed on the ablation foci, and the results of CEUS examination were compared with the pathological findings. Results In this study, a total of 31 twice radiofrequency ablation foci were produced in 7 live pigs,real time CEUS evaluation revealed 10 incomplete ablation and 21 complete ablation, pathological findings showed 9 incomplete ablation and 22 complete ablation. The complete ablation rate of twice RFA guided by real-time CEUS was 71%, and the incomplete ablation rate was 29%. The accuracy of real time CEUS for the determination of residual ablation was 83.9%, the sensitivity was 77.8%, and the specificity was 86.3%. The McNemar test results of CEUS and pathological examination to determine whether the ablation site was fully ablated were P>0.05, the difference was not statistically significant, indicating that the two judgments were consistent. Another 3 live pig liver multiple radiofrequency ablation experiments, confirmed that there were no residual ablation foci judged by CEUS. The pathological findings also confirmed that there was no residual.During pathological examination, residual normal hepatocytes were also found in the residual ablation foci. Conclusion Real time CEUS can accurately guide the living pig liver to carry on many times RFA, and it can provide a reliable imaging basis for the evaluation of multiple RFA effects of live pig liver. |
| keywords:Liver Radiofrequency ablation Contrast-enhanced ultrasound Animal experimentation |
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