發(fā)布時(shí)間：2018-03-21 20:11

  本文選題：肝臟　切入點(diǎn)：射頻消融　出處：《山東醫(yī)藥》2017年10期 　論文類型：期刊論文

【摘要】：目的對比分析常規(guī)超聲和超聲造影實(shí)時(shí)判斷活體豬肝射頻消融(RFA)效果的價(jià)值。方法對10只小型活體豬肝進(jìn)行RFA,術(shù)后即刻行常規(guī)超聲和超聲造影檢查,處死后切取消融灶行病理檢查;比較三種檢查方法測得的消融灶范圍,以組織切片病理檢查結(jié)果為標(biāo)準(zhǔn)分析超聲造影判斷消融灶是否完全消融的價(jià)值。結(jié)果 10只活體豬肝共產(chǎn)生43個(gè)消融灶,常規(guī)超聲所測消融灶左右徑、垂直徑及所計(jì)算出的面積均小于大體標(biāo)本(P均㩳0.05),二者各指標(biāo)均相關(guān)(r分別為0.977、0.943、0.956,P均㩳0.05);超聲造影所測消融灶左右徑、垂直徑及所計(jì)算出的面積均與大體標(biāo)本差異無統(tǒng)計(jì)學(xué)意義(P均0.05),二者各指標(biāo)均相關(guān)(r分別為0.949、0.958、0.919,P均㩳0.05)。組織切片病理檢查判斷30個(gè)消融灶不完全消融、13個(gè)完全消融,超聲造影判斷28個(gè)消融灶不完全消融、15個(gè)完全消融。超聲造影判斷消融灶的準(zhǔn)確率為81.4%、靈敏性為83.3%、特異性為76.9%、陽性預(yù)測值為89.3%、陰性預(yù)測值為66.7%、漏診率為16.7%、陽性似然比為3.61、陰性似然比0.22,與組織切片病理檢查判斷消融灶是否完全消融的結(jié)果相一致(P=0.727)。結(jié)論在RFA術(shù)后常規(guī)超聲實(shí)時(shí)判斷活體豬肝射頻消融灶范圍的價(jià)值有限,超聲造影能夠?yàn)镽FA術(shù)后實(shí)時(shí)判斷活體豬肝射頻消融灶范圍及是否完全消融提供可靠的影像學(xué)判斷依據(jù)。
[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.
【作者單位】： 貴州醫(yī)科大學(xué)附屬人民醫(yī)院;
【基金】：貴州省科技廳聯(lián)合基金資助項(xiàng)目(黔科合LH字2014-7016號(hào))
【分類號(hào)】：R445.1;R735.7

【參考文獻(xiàn)】

相關(guān)期刊論文 前3條

1 羅敏;時(shí)美欣;張巍;張羽;楊秀華;丁紅;;影響肝細(xì)胞癌射頻消融術(shù)后療效的相關(guān)因素分析[J];中華醫(yī)學(xué)超聲雜志(電子版);2015年06期

2 吳鉞;張曦彤;宋慶宏;王磊;張四洋;劉靜;李海偉;;CT鑒別兔肝VX2腫瘤射頻消融后殘余瘤與炎癥反應(yīng)[J];實(shí)用肝臟病雜志;2010年03期

3 廖錦堂;潘瑞U，

本文編號(hào)：1645365