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剪切波弹性成像评价微波消融治疗肝恶性肿瘤疗效的初步探讨

Preliminary Exploration on the Value of Shear Wave Elastography in Evaluating the Effectiveness of Microwave Ablation on Hepatic Malignancies.

机构信息

Departments of Ultrasound Imaging.

Thoracic Surgery, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, Guangdong Province, China.

出版信息

Ultrasound Q. 2022 Jun 1;38(2):160-164. doi: 10.1097/RUQ.0000000000000606.

Abstract

Shear wave elastography (SWE) is a new type of ultrasonic elastography that can quantitatively assess the elasticity and stiffness of tissues. This study aimed to investigate the value of SWE in evaluating the effectiveness of microwave ablation in hepatic malignancies. A total of 24 patients (including 30 lesions) with liver malignancies receiving microwave ablation treatment at the Cancer Hospital of Guangzhou Medical University from April 2018 to January 2019 were enrolled. The elastography was performed within 1 week before and after ablation. The SWE values in the central zone, the marginal zone of the lesion, and peripheral liver parenchyma were collected and analyzed. Before ablation, the mean of SWE value was 65.80 ± 13.37 kPa for the central zone of the tumor and 39.93 ± 7.87 kPa for the marginal zone, both of which were significantly greater than that for the perinatal liver parenchyma (12.85 ± 2.67 kPa, both P < 0.05). In the central and marginal zone of the lesions, the SWE value was significantly elevated after ablation (both P < 0.001) but not in the peripheral liver parenchyma (P = 0.444). Receiver operating characteristic curve analysis showed that the cutoff value for ablation in the marginal zone was 53.87 kPa, suggesting that an SWE exceeding 53.87 kPa is an index guaranteeing the ablation effectiveness. These results suggested that SWE has the potential to be used in evaluating the effectiveness of microwave ablation in liver cancers.

摘要

剪切波弹性成像(SWE)是一种新型的超声弹性成像技术,可以定量评估组织的弹性和硬度。本研究旨在探讨 SWE 在评估微波消融治疗肝恶性肿瘤疗效中的价值。共纳入 2018 年 4 月至 2019 年 1 月在广州医科大学附属肿瘤医院接受微波消融治疗的 24 例(30 个病灶)肝恶性肿瘤患者。在消融前和消融后 1 周内行弹性成像检查。收集并分析病灶中央区、边缘区及周围肝实质的 SWE 值。消融前肿瘤中央区 SWE 值的平均值为 65.80±13.37kPa,边缘区为 39.93±7.87kPa,均显著高于周围肝实质的 12.85±2.67kPa(均 P<0.05)。病灶中央区和边缘区的 SWE 值在消融后显著升高(均 P<0.001),而周围肝实质无明显变化(P=0.444)。受试者工作特征曲线分析显示,边缘区的消融截断值为 53.87kPa,提示 SWE 超过 53.87kPa 是保证消融效果的指标。这些结果表明 SWE 有可能用于评估微波消融治疗肝癌的疗效。

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