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目的 :研究增强螺旋CT(MDCT)及超声造影(CEUS)评估高强度聚焦超声(HIFU)消融兔肝癌疗效的价值。方法 :对兔肝癌模型动物行HIFU治疗,在治疗前后1小时内行MDCT和CEUS检查,结合病理学结果比较影像学的评估价值。结果 :MDCT和CEUS对完全消融者表现为肿瘤区域无增强。对消融不全者,MDCT表现为肿瘤区域内动脉期灶性的高密度强化信号,门脉期密度低于周围肝脏实质;CEUS表现为肿瘤区域内动脉期早期异常的高回声增强灶,动脉期晚期或门脉相早期快速消退呈低回声增强。MDCT和CEUS对消融不全的诊断准确性分别为90.9%和81.8%,MDCT与CEUS二者联合的诊断准确性为95.4%,均明显高于单用CECT或CEUS法。结论 :MDCT和CEUS均可以较为准确的对兔肝VX2肿瘤HIFU消融后的疗效进行即时评估,两者联合评价可提高诊断准确率。
Objective: To investigate the value of enhanced spiral CT (MDCT) and contrast-enhanced ultrasonography (CEUS) in assessing the therapeutic effect of high intensity focused ultrasound (HIFU) on rabbit liver cancer. Methods: HIFU was treated in HCC in rabbits with HCC. The MDCT and CEUS were performed within 1 hour before and after treatment. The imaging evaluation was compared with pathological results. Results: MDCT and CEUS showed no enhancement of tumor area for complete ablation. In patients with ablation, MDCT manifested as arterial phase focal hyperintensity signals in the tumor region, and portal venous densities were lower than those in the surrounding liver. CEUS showed abnormal hyperechoic lesions in the arterial phase early in the arterial phase, Or rapid early regression of portal phase hypoechoic enhancement. The diagnostic accuracy of MDCT and CEUS for the diagnosis of ablation were 90.9% and 81.8%, respectively. The diagnostic accuracy of MDCT and CEUS was 95.4%, which were significantly higher than those of CECT or CEUS alone. Conclusion: Both MDCT and CEUS can be used to evaluate the curative effect of HIFU ablation in rabbit VX2 tumors. The combined evaluation can improve the diagnostic accuracy.