本文選題：聲脈沖輻射力成像技術(shù)　切入點：肝細胞癌　出處：《廣西醫(yī)科大學》2017年碩士論文

【摘要】：目的:探討聲脈沖輻射力成像技術(shù)(acoustic radiation force impulse,ARFI)早期評估肝細胞性肝癌(hepathocellcular carcinoma,HCC)射頻消融(radiofrequency ablation,RFA)療效的臨床應(yīng)用價值。材料和方法:2015年12月~2016年6月我院行射頻消融治療的22例患者共23個HCC病灶納入本研究。所有病灶均經(jīng)穿刺活檢病理或臨床證實為HCC。分別于RFA術(shù)前1周、術(shù)后24h及術(shù)后1個月行常規(guī)超聲、超聲造影(contrast enhanced ultrasound,CEUS)及ARFI檢查,用常規(guī)超聲、CEUS及ARFI的聲觸診組織彈性成像(virtual touch tissue imaging,VTI)技術(shù)測量消融灶最大長軸及最大短軸,計算消融灶面積,以消融灶面積表示消融范圍,對比不同時間點三種方法對消融灶范圍的顯示情況;用ARFI的聲觸診組織量化(virtual touch tissue quantification,VTQ)軟件測量不同時間點消融灶內(nèi)部、邊緣及周邊肝實質(zhì)VTQ值,比較RFA術(shù)前、術(shù)后消融灶不同區(qū)域硬度變化。結(jié)果:23個消融灶RFA術(shù)后24h及術(shù)后1個月VTI彈性圖均表現(xiàn)為黑暗色(質(zhì)硬),較術(shù)前質(zhì)硬,邊界清晰,范圍增大。術(shù)后24h消融灶內(nèi)部及邊緣VTQ值較術(shù)前明顯升高,差異有統(tǒng)計學意義(P0.01、P0.01),與術(shù)后1個月比較差異無統(tǒng)計學意義(P=0.46、P=0.50);術(shù)后24h及術(shù)后1個月消融灶周邊肝實質(zhì)VTQ值較術(shù)前差異無統(tǒng)計學意義(P=0.74,P=0.92)。RFA術(shù)前BUS、CEUS及ARFI顯示病灶面積比較差異無統(tǒng)計學意義(P=0.81),術(shù)后24h及術(shù)后1個月ARFI與CEUS顯示消融灶面積比較均無統(tǒng)計學差異(P=0.88、P=0.49),與BUS比較差異有統(tǒng)計學意義(P0.01,P0.01)。結(jié)論:ARFI能夠清晰顯示RFA術(shù)后24h消融灶范圍,與CEUS結(jié)果相似,優(yōu)于BUS,并能定量反應(yīng)消融灶硬度變化情況,為早期判斷消融效果提供重要依據(jù)。
[Abstract]:Objective: to evaluate the clinical value of acoustic pulse radiography (radiation) technique for early evaluation of radiofrequency ablation of hepatocellular carcinoma (HCC) with radiofrequency ablation (RFA). Materials and methods: radiofrequency ablation of hepatocellular carcinoma from December 2015 to June 2016. A total of 23 HCC lesions were included in this study in 22 patients. 24 hours after operation and 1 month after operation, conventional ultrasound, contrast enhanced ultrasound usus and ARFI were performed. The maximum long axis and the maximum short axis of ablation were measured by using the technique of conventional ultrasound CEUs and ARFI with virtual touch tissue imagingVTI, and the ablation area was calculated. The extent of ablation was expressed by the area of ablation, and the extent of ablation was compared with three methods at different time points, and the VTQ values of liver parenchyma in different time points were measured by using ARFI's acoustic palpation tissue quantification and virtual touch tissue quantification (VTQQ) software. Results: 24 hours after RFA and 1 month after RFA, the changes of hardness in different regions of the ablation focus were compared. Results: the VTI elastogram of 23 ablation foci showed dark color, which was more rigid than that before RFA, and the boundary was clear. The VTQ value of the ablation focus was significantly higher than that of the preoperative ablation at 24 hours after ablation. The difference was statistically significant (P 0.01) and there was no significant difference compared with one month after operation. The VTQ value of hepatic parenchyma around ablation focus 24 hours after operation and 1 month after operation were not significantly different from those before operation. There was no significant difference between preoperative VTQ and preoperative BUSCEUS and ARFI. There was no significant difference in ablation area between ARFI and CEUS 24 hours after operation and 1 month after operation. There was no significant difference in ablation area between ARFI and CEUS, but there was significant difference compared with BUS. Conclusion the range of ablation foci at 24 hours after RFA can be clearly demonstrated by ARFI. The results were similar to those of CEUS, and were superior to those of bus, and could quantitatively reflect the change of ablation focus hardness, which provided an important basis for early evaluation of ablation effect.
【學位授予單位】：廣西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R445.1;R735.7

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本文編號：1681560