利用静脉注射造影剂的C型臂计算机断层扫描评估肝脏肿瘤的消融边缘
Ablation margin assessment of liver tumors with intravenous contrast-enhanced C-arm computed tomography.
作者信息
Iwazawa Jin, Ohue Shoichi, Hashimoto Naoko, Mitani Takashi
机构信息
Jin Iwazawa, Naoko Hashimoto, Takashi Mitani, Department of Radiology, Nissay Hospital, 6-3-8 Itachibori, Nishiku, Osaka 550-0012, Japan.
出版信息
World J Radiol. 2012 Mar 28;4(3):109-14. doi: 10.4329/wjr.v4.i3.109.
AIM
To evaluate the feasibility of intravenous contrast-enhanced C-arm computed tomography (CT) for assessing ablative areas and margins of liver tumors.
METHODS
Twelve patients (5 men, 7 women; mean age, 69.5 years) who had liver tumors (8 hepatocellular carcinomas, 4 metastatic liver tumors; mean size, 16.3 mm; size range, 8-20 mm) and who underwent percutaneous radiofrequency ablations (RFAs) with a flat-detector C-arm system were retrospectively reviewed. Intravenously enhanced C-arm CT and multidetector computed tomography (MDCT) images were obtained at the end of the RFA sessions and 3-7 d after RFA to evaluate the ablative areas and margins. The ablated areas and margins were measured using axial plane images acquired by both imaging techniques, with prior contrast-enhanced MDCT images as the reference. The sensitivity, specificity, and positive and negative predictive values of C-arm CT for detecting insufficient ablative margins (< 5 mm) were calculated. Statistical differences in the ablative areas and margins evaluated with both imaging techniques were compared using a paired t-test.
RESULTS
All RFA procedures were technically successful. Of 48 total ablative margins, 19 (39.6%) and 20 (41.6%) margins were found to be insufficient with C-arm CT and MDCT, respectively. Moreover, there were no significant differences between these 2 imaging techniques in the detection of these insufficient ablative margins. The sensitivity, specificity, and positive and negative predictive values for detecting insufficient margins by C-arm CT were 90.0%, 96.4%, 94.7% and 93.1%, respectively. The mean estimated ablative areas calculated from C-arm CT (462.5 ± 202.1 mm(2)) and from MDCT (441.2 ± 212.5 mm(2)) were not significantly different. The mean ablative margins evaluated by C-arm CT (6.4 ± 2.2 mm) and by MDCT (6.0 ± 2.4 mm) were also not significantly different.
CONCLUSION
The efficacy of intravenous contrast-enhanced C-arm CT in assessing the ablative areas and margins after RFA of liver tumors is nearly equivalent to that of MDCT.
目的
评估静脉注射对比剂的C型臂计算机断层扫描（CT）用于评估肝肿瘤消融区域和边缘的可行性。
方法
回顾性分析12例肝肿瘤患者（5例男性，7例女性；平均年龄69.5岁），这些患者有肝肿瘤（8例肝细胞癌，4例肝转移瘤；平均大小16.3 mm；大小范围8 - 20 mm），并使用平板探测器C型臂系统进行了经皮射频消融（RFA）。在RFA结束时以及RFA后3 - 7天获取静脉增强C型臂CT和多排探测器计算机断层扫描（MDCT）图像，以评估消融区域和边缘。使用两种成像技术获取的轴位图像测量消融区域和边缘，以增强MDCT图像作为参考。计算C型臂CT检测消融边缘不足（< 5 mm）的敏感性、特异性、阳性预测值和阴性预测值。使用配对t检验比较两种成像技术评估的消融区域和边缘的统计学差异。
结果
所有RFA手术在技术上均成功。在总共48个消融边缘中，C型臂CT和MDCT分别发现19个（39.6%）和20个（41.6%）边缘不足。此外，在检测这些消融边缘不足方面，这两种成像技术之间没有显著差异。C型臂CT检测边缘不足的敏感性、特异性、阳性预测值和阴性预测值分别为90.0%、96.4%、94.7%和93.1%。由C型臂CT（462.5 ± 202.1 mm²）和MDCT（441.2 ± 212.5 mm²）计算的平均估计消融区域没有显著差异。C型臂CT（6.4 ± 2.2 mm）和MDCT（6.0 ± 2.4 mm）评估的平均消融边缘也没有显著差异。
结论
静脉注射对比剂的C型臂CT在评估肝肿瘤RFA后的消融区域和边缘方面其效能与MDCT几乎相当。
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