超声造影与磁共振成像融合成像在常规超声难以检测的肝细胞癌检测中的应用

Application of imaging fusion combining contrast-enhanced ultrasound and magnetic resonance imaging in detection of hepatic cellular carcinomas undetectable by conventional ultrasound.

作者信息

Dong Yi, Wang Wen-Ping, Mao Feng, Ji Zheng-Biao, Huang Bei-Jian

机构信息

Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China.

Institute of Medical Ultrasound and Engineering, Fudan University, Shanghai, China.

出版信息

J Gastroenterol Hepatol. 2016 Apr;31(4):822-8. doi: 10.1111/jgh.13202.

DOI:10.1111/jgh.13202

PMID:26480287

Abstract

BACKGROUND AND AIM

The aim of this study is to explore the value of volume navigation image fusion-assisted contrast-enhanced ultrasound (CEUS) in detection for radiofrequency ablation guidance of hepatocellular carcinomas (HCCs), which were undetectable on conventional ultrasound.

METHODS

From May 2012 to May 2014, 41 patients with 49 HCCs were included in this study. All lesions were detected by dynamic magnetic resonance imaging (MRI) and planned for radiofrequency ablation but were undetectable on conventional ultrasound. After a bolus injection of 2.4 ml SonoVue® (Bracco, Italy), LOGIQ E9 ultrasound system with volume navigation system (version R1.0.5, GE Healthcare, Milwaukee, WI, USA) was used to fuse CEUS and MRI images. The fusion time, fusion success rate, lesion enhancement pattern, and detection rate were analyzed.

RESULTS

Image fusions were conducted successfully in 49 HCCs, the technical success rate was 100%. The average fusion time was (9.2 ± 2.1) min (6-12 min). The mean diameter of HCCs was 25.2 ± 5.3 mm (mean ± SD), and mean depth was 41.8 ± 17.2 mm. The detection rate of HCCs using CEUS/MRI imaging fusion (95.9%, 47/49) was significantly higher than CEUS (42.9%, 21/49) (P < 0.05). For small HCCs (diameter, 1-2 cm), the detection rate using imaging fusion (96.9%, 32/33) was also significantly higher than CEUS (18.2%, 6/33) (P < 0.01). All HCCs displayed a rapid wash-in pattern in the arterial phase of CEUS.

CONCLUSIONS

Imaging fusion combining CEUS and MRI is a promising technique to improve the detection, precise localization, and accurate diagnosis of undetectable HCCs on conventional ultrasound, especially small and atypical HCCs.

摘要

背景与目的

本研究旨在探讨容积导航图像融合辅助的超声造影（CEUS）在常规超声无法检测到的肝细胞癌（HCC）射频消融引导检测中的价值。

方法

2012年5月至2014年5月，本研究纳入了41例患有49个HCC的患者。所有病灶均通过动态磁共振成像（MRI）检测到并计划进行射频消融，但在常规超声上无法检测到。在静脉推注2.4 ml SonoVue®（意大利Bracco公司）后，使用带有容积导航系统（版本R1.0.5，美国通用电气医疗集团，威斯康星州密尔沃基）的LOGIQ E9超声系统对CEUS和MRI图像进行融合。分析融合时间、融合成功率、病灶增强模式和检测率。

结果

49个HCC均成功进行了图像融合，技术成功率为100%。平均融合时间为（9.2±2.1）分钟（6 - 12分钟）。HCC的平均直径为25.2±5.3毫米（平均值±标准差），平均深度为41.8±17.2毫米。使用CEUS/MRI成像融合检测HCC的比率（95.9%，47/49）显著高于CEUS（42.9%，21/49）（P < 0.05）。对于小HCC（直径1 - 2厘米），使用成像融合的检测率（96.9%，32/33）也显著高于CEUS（18.2%，6/33）（P < 0.01）。所有HCC在CEUS动脉期均表现为快速增强模式。