去血管化治疗后神经内分泌肝脏转移瘤的超声造影:功能和形态学评估。

Contrast-enhanced ultrasound after devascularisation of neuroendocrine liver metastases: functional and morphological evaluation.

机构信息

Hospices Civils de Lyon, Hôpital Edouard Herriot, Service d'Imagerie Digestive, 69437 Lyon cedex 03, France.

出版信息

Eur Radiol. 2013 Mar;23(3):805-15. doi: 10.1007/s00330-012-2646-4. Epub 2012 Sep 22.

Abstract

OBJECTIVE

To evaluate morphological and perfusion changes in liver metastases of neuroendocrine tumours by contrast-enhanced ultrasound (CEUS) after transarterial embolisation with bead block (TAE) or trans-arterial chemoembolisation with doxorubicin-eluting beads (DEB-TACE).

METHODS

In this retrospective study, seven patients underwent TAE, and ten underwent DEB-TACE using beads of the same size. At 1 day before embolisation, 2 days, 1 month and 3 months after the procedure, a destruction-replenishment study using CEUS was performed with a microbubble-enhancing contrast material on a reference tumour. Relative blood flow (rBF) and relative blood volume (rBV) were obtained from the ratio of values obtained in the tumour and in adjacent liver parenchyma. Morphological parameters such as the tumour's major diameter and the viable tumour's major diameter were also measured. A parameter combining functional and morphological data, the tumour vitality index (TVI), was studied. The Wilcoxon rank-sum test and Fisher's test were used to compare treatment groups.

RESULTS

At 3 months rBF, rBV and TVI were significantly lower (P = 0.005, P = 0.04 and P = 0.03) for the group with doxorubicin. No difference in morphological parameters was found throughout the follow-up.

CONCLUSIONS

One parameter, TVI, could evaluate the morphological and functional response to treatments.

摘要

目的

通过对比增强超声(CEUS)评估神经内分泌肿瘤肝转移经动脉栓塞术(TAE)或载多柔比星微球的经动脉化疗栓塞术(DEB-TACE)后形态和灌注变化。

方法

本回顾性研究纳入了 7 例接受 TAE 和 10 例接受 DEB-TACE 的患者,均使用相同大小的微球。在栓塞前 1 天、栓塞后 2 天、1 个月和 3 个月,对参考肿瘤进行 CEUS 破坏-再灌注研究,使用微泡增强造影剂。从肿瘤和相邻肝实质中获得的值的比值获得相对血流(rBF)和相对血容量(rBV)。还测量了肿瘤的最大直径和存活肿瘤的最大直径等形态学参数。研究了一种结合功能和形态学数据的参数,即肿瘤活力指数(TVI)。采用 Wilcoxon 秩和检验和 Fisher 检验比较治疗组。

结果

在 3 个月时,rBF、rBV 和 TVI 在多柔比星组显著降低(P=0.005、P=0.04 和 P=0.03)。在整个随访过程中,形态学参数无差异。

结论

一个参数,即 TVI,可评估治疗的形态和功能反应。

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