Shiozawa Kazue, Watanabe Manabu, Takayama Ryuji, Takahashi Masayoshi, Wakui Noritaka, Iida Kazunari, Sumino Yasukiyo
Department of Gastroenterology and Hepatology, Toho University Medical Center, Omori Hospital, 6-11-1, Omorinishi, Ota-ku, Tokyo 143-8541, Japan.
J Clin Ultrasound. 2010 May;38(4):182-9. doi: 10.1002/jcu.20685.
To evaluate the effectiveness of contrast-enhanced ultrasonography (CEUS) using Sonazoid for the diagnosis of the local recurrence after treatment for hepatocellular carcinoma (HCC) by comparing it with dynamic CT.
Seventy-one patients with 87 HCC lesions (mean +/- SD; 19.5 +/- 9.6 mm) underwent CEUS using Sonazoid and dynamic CT after radiofrequency ablation (n = 55), transcatheter arterial chemoembolization (n = 22), or radiofrequency ablation combined with transcatheter arterial chemoembolization (n = 10). Two hepatologists (observer 1; 10 years of experience, and 2; 20 years of experience) reviewed the CEUS and dynamic CT images independently and evaluated presence or absence of the local recurrence. Diagnostic performance for the local recurrence was assessed using receiver operating characteristic curve analysis.
The Az value for dynamic CT was significantly lower in observer 1 than 2 (p < 0.05). The sensitivity of CEUS was 79% in observer 1 and 83.9% in observer 2, and that of dynamic CT was 83.9% and 90.3%, respectively. The specificity of CEUS was 96%, and that of dynamic CT was 92%, in both observers.
This study suggests that CEUS using Sonazoid is less affected by the observer's experience and is more accurate in the diagnosis of local recurrence after treatment for HCC than dynamic CT.
通过与动态CT对比,评估使用声诺维的超声造影(CEUS)对肝细胞癌(HCC)治疗后局部复发的诊断效果。
71例患者共87个HCC病灶(平均±标准差;19.5±9.6 mm),在接受射频消融(n = 55)、经动脉化疗栓塞(n = 22)或射频消融联合经动脉化疗栓塞(n = 10)后,接受了使用声诺维的CEUS和动态CT检查。两名肝病专家(观察者1,经验10年;观察者2,经验20年)独立回顾CEUS和动态CT图像,并评估局部复发的有无。使用受试者工作特征曲线分析评估局部复发的诊断性能。
观察者1中动态CT的Az值显著低于观察者2(p < 0.05)。观察者1中CEUS的敏感性为79%,观察者2中为83.9%,动态CT的敏感性分别为83.9%和90.3%。两名观察者中,CEUS的特异性均为96%,动态CT的特异性均为92%。
本研究表明,使用声诺维的CEUS受观察者经验的影响较小,在诊断HCC治疗后的局部复发方面比动态CT更准确。