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结直肠癌肝转移热消融术前对比增强超声的环状强化与热消融后早期肝内进展的关系:一项初步研究

The Relationship Between Rim-like Enhancement on Pre-ablation Contrast-enhanced Ultrasound of Colorectal Liver Metastasis and Early Intrahepatic Progression After Thermal Ablation: A Preliminary Study.

作者信息

Lin Jia, Liu Huahui, Liang Shuang, Luo Liping, Guan Sainan, Wu Shanshan, Liu Ying, Xu Shuxian, Yan Ronghua, Xu Erjiao

机构信息

Department of Medical Ultrasonics, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong, China.

Department of Radiology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China.

出版信息

Ultrasound Med Biol. 2025 Feb;51(2):358-363. doi: 10.1016/j.ultrasmedbio.2024.10.015. Epub 2024 Nov 12.

Abstract

OBJECTIVE

To investigate the relationship between the rim-like enhancement pattern on pre-ablation contrast-enhanced ultrasound (CEUS) of colorectal liver metastasis (CRLM) and the therapeutic efficacy of percutaneous microwave ablation (MWA).

METHODS

Patients with CRLM underwent MWA and were evaluated using CEUS before ablation in our hospital between February 2020 and February 2023 were enrolled in this retrospective study. The enhancement patterns of CRLM were assessed by two radiologists and classified as rim-like enhancement and non-rim-like enhancement patterns. The therapeutic outcomes, including cumulative intrahepatic progression rate and early intrahepatic progression rate, were followed up and analyzed.

RESULTS

Overall, 50 patients with 121 nodules were enrolled. Rim-like enhancement pattern was observed in 18 patients (18/50, 36.0%). The cumulative intrahepatic progression rate was significantly higher in the rim-like enhancement group than the rate in the non-rim-like enhancement group (p = 0.022). The early intrahepatic progression rate in the rim-like enhancement group was also significantly higher than the rate in the non-rim-like enhancement group (12/17, 70.6% vs. 6/24, 25.0%, p = 0.005). The multivariable analysis demonstrated that the rim-like enhancement pattern of CRLM was a significant risk factor associated with early intrahepatic progression after MWA (p = 0.013).

CONCLUSION

Rim-like enhancement pattern on pre-ablation CEUS of CRLM was associated with a higher risk of intrahepatic progression after MWA.

摘要

目的

探讨结直肠癌肝转移(CRLM)消融前对比增强超声(CEUS)的边缘样强化模式与经皮微波消融(MWA)治疗效果之间的关系。

方法

本回顾性研究纳入了2020年2月至2023年2月在我院接受MWA治疗且消融前接受CEUS评估的CRLM患者。由两名放射科医生评估CRLM的强化模式,并分为边缘样强化和非边缘样强化模式。对治疗结果进行随访分析,包括累积肝内进展率和早期肝内进展率。

结果

共纳入50例患者,121个结节。18例患者(18/50,36.0%)观察到边缘样强化模式。边缘样强化组的累积肝内进展率显著高于非边缘样强化组(p = 0.022)。边缘样强化组的早期肝内进展率也显著高于非边缘样强化组(12/17,70.6%对6/24,25.0%,p = 0.005)。多变量分析表明,CRLM的边缘样强化模式是MWA后早期肝内进展的一个显著危险因素(p = 0.013)。

结论

CRLM消融前CEUS的边缘样强化模式与MWA后肝内进展风险较高相关。

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