Department of Digestive Disease, Xiamen Chang Gung Hospital Hua Qiao University, Xiamen, China.
Department of Gastroenterology and Hepatology, Linkou Branch, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
BMC Med Imaging. 2024 Nov 28;24(1):323. doi: 10.1186/s12880-024-01508-w.
This study evaluated the impact of contrast-enhanced ultrasonography (CEUS) combined with CT or MRI fusion imaging on percutaneous radiofrequency ablation (RFA) outcomes for hepatocellular carcinoma (HCC) inconspicuous on conventional ultrasonography (US).
Patients were categorized into US-inconspicuous (USI) and US-conspicuous (USC) groups based on US imaging. The parameters of viable HCCs ⎯ including diameter, location, and RFA efficacy ⎯ were compared between USI and USC groups. Moreover, the breathing fusion imaging errors were measured. The differences in technical success, technical efficacy, local tumor progression, new tumor occurrence, and overall survival rate between USI and USC groups were analyzed.
Sixty-five patients with 106 lesions were included. CEUS showed high consistency with CT/MRI but revealed larger diameters (p < 0.001) and more feeding arteries (p = 0.019) than CT/MRI. Breathing fusion imaging errors averaged 17 ± 4 mm, significantly affecting lesions in segments II, III, V, and VI (p < 0.001). The USI group had more lesions ablated per patient in a single RFA procedure (p = 0.001) than the USC group. No significant differences were observed in technical success rate, technical efficacy rate, local tumor progression rate, and overall survival rate between the two groups.
CEUS combined with fusion imaging provides detailed information on viable HCCs and their feeding arteries. CEUS-guided RFA avoids fusion imaging errors and achieves comparable efficacy in both US-conspicuous and US-inconspicuous HCCs.
本研究评估了超声造影（CEUS）联合 CT 或 MRI 融合成像对常规超声（US）不明显的肝细胞癌（HCC）经皮射频消融（RFA）疗效的影响。
根据 US 影像学将患者分为 US 不明显（USI）和 US 明显（USC）两组。比较 USI 和 USC 两组之间有活力 HCC 的参数（包括直径、位置和 RFA 疗效）。此外，还测量了呼吸融合成像误差。分析 USI 和 USC 两组之间的技术成功率、技术疗效、局部肿瘤进展、新发肿瘤发生和总生存率的差异。
共纳入 65 例 106 个病灶患者。CEUS 与 CT/MRI 具有高度一致性，但显示出更大的直径（p<0.001）和更多的供血动脉（p=0.019）。呼吸融合成像误差平均为 17±4mm，显著影响 II、III、V 和 VI 段的病灶（p<0.001）。单次 RFA 治疗中，USI 组每个患者消融的病灶数多于 USC 组（p=0.001）。两组之间技术成功率、技术疗效率、局部肿瘤进展率和总生存率无显著差异。
CEUS 联合融合成像可提供有活力 HCC 及其供血动脉的详细信息。CEUS 引导的 RFA 可避免融合成像误差，并在 US 明显和 US 不明显 HCC 中达到相似的疗效。
