Bartolotta Tommaso Vincenzo, Taibbi Adele, Matranga Domenica, Midiri Massimo, Lagalla Roberto
Department of Radiology, University of Palermo, Via Del Vespro 127, 90129, Palermo, Italy,
Radiol Med. 2015 Aug;120(8):695-704. doi: 10.1007/s11547-015-0514-4. Epub 2015 Feb 20.
To investigate diagnostic performance of 3D contrast-enhanced ultrasound (CEUS) compared with 2D CEUS in the assessment of therapeutic response of hepatocellular carcinoma (HCC) treated with locoregional therapies (LRT).
Twenty-three consecutive patients (13 men and 10 women; mean age 65.5 years) with 23 HCCs (size range 1.2-7.2 cm; mean size 2.9 ± 1.4 cm) treated by means of radiofrequency ablation (RFA n = 9), transarterial chemoembolization (TACE n = 8), combined RFA and TACE (n = 3), percutaneous alcoholization (n = 2), and wedge resection (n = 1) underwent 2D and 3D CEUS 1 month (30 ± 2 days) after treatment. Magnetic resonance (n = 17) and computed tomography (n = 6) acted as standard of reference (SOR). Two radiologists assessed the absence (complete response CR) or presence (residual tumor RT) of any nodular arterially enhancing area within or along the margin of the treated HCC.
Both 2D and 3D CEUS observed CR in 10/23 (43.5 %) HCCs and RT in 11/23 (47.8 %) HCCs. In 1/23 (4.3 %) HCC, RT was documented by SOR and 2D CEUS, but it was not appreciable at 3D CEUS. In 1/23 (4.3 %) HCC, the presence of peripheral residual tumor was suspected by both 2D and 3D CEUS, but it was not confirmed by SOR. No statistically significant difference between 2D and 3D CEUS in depicting either CR or RT was found (p > 0.05). Sensitivity, specificity, positive and negative predictive values, and accuracy of 3D CEUS were 91.7 % [95 % confidence interval (CI) 0.760-1.073], 90.9 % (95 % CI 0.739-1.079), 91.7, 90.9, and 91.3 %, respectively.
2D and 3D CEUS provided similar diagnostic performance in the assessment of therapeutic response of HCC treated with LRT.
探讨三维对比增强超声（CEUS）与二维CEUS在评估经局部区域治疗（LRT）的肝细胞癌（HCC）治疗反应中的诊断性能。
连续23例患者（13例男性，10例女性；平均年龄65.5岁），患有23个HCC（大小范围1.2 - 7.2 cm；平均大小2.9±1.4 cm），接受了射频消融（RFA，n = 9）、经动脉化疗栓塞（TACE，n = 8）、RFA与TACE联合治疗（n = 3）、经皮乙醇注射（n = 2）以及楔形切除术（n = 1），在治疗后1个月（30±2天）接受二维和三维CEUS检查。磁共振成像（n = 17）和计算机断层扫描（n = 6）作为参考标准（SOR）。两名放射科医生评估治疗后的HCC内部或边缘是否存在任何结节状动脉期强化区域（无强化为完全缓解CR，有强化为残留肿瘤RT）。
二维和三维CEUS均观察到10/23（43.5%）的HCC为CR，11/23（47.8%）的HCC为RT。在1/23（4.3%）的HCC中，SOR和二维CEUS记录到RT，但三维CEUS未观察到。在1/23（4.3%）的HCC中，二维和三维CEUS均怀疑存在周边残留肿瘤，但SOR未证实。二维和三维CEUS在描绘CR或RT方面未发现统计学显著差异（p>0.05）。三维CEUS的敏感性、特异性、阳性和阴性预测值以及准确性分别为91.7%[95%置信区间（CI）0.760 - 1.073]、90.9%（95%CI 0.739 - 1.079）、91.7、90.9和91.3%。
二维和三维CEUS在评估经LRT治疗的HCC治疗反应中具有相似的诊断性能。
