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首页> 外文期刊>Digestive diseases >Contrast-Enhanced Ultrasound in the Short-Term Evaluation of Hepatocellular Carcinoma after Locoregional Treatment
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Contrast-Enhanced Ultrasound in the Short-Term Evaluation of Hepatocellular Carcinoma after Locoregional Treatment

机译：对比度增强超声在患者肝细胞癌后的短期评价中

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Background: Contrast-enhanced ultrasound (CEUS) with second-generation contrast agents performed 1 month after hepatocellular carcinoma (HCC) treatment is almost as sensitive as contrast-enhanced computed tomography (CECT) in depicting the residual tumor. However, the efficacy of CEUS performed early after the procedure is still debated. Aim: We evaluated the diagnostic accuracy (DA) of CEUS for the assessment of tumor response shortly after locoregional therapy in patients with unresectable HCC. Methods: Ninety-four patients with 104 HCC lesions who were scheduled to receive percutaneous ethanol injection, radiofrequency ablation, transcatheter arterial chemoembolization, or combined treatment were enrolled in this study. With CECT at 1-month as the reference standard, the DA of CEUS performed 48-h after the procedure was evaluated. Patients were followed-up to look for tumor or disease progression. Results: Based on CECT findings, 43/104 lesions were diagnosed as having residual viability after 1?month. CEUS performed 48 h after treatment detected residual tumor in 34/43 nodules with treatment failure at CECT with a sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 79.1, 96.7, 94.4, 86.8, and 89%, respectively. There was a high degree of concordance between CEUS and CECT (kappa coefficient = 0.78). A hyperemic halo was detectable in 35 lesions without a statistically significant difference between concordant and discordant cases. In patients with uninodular disease responders according to 48 h CEUS had a significantly longer mean overall survival and time to progression compared to nonresponders. Conclusion: CEUS performed 48 h after treatment can be considered a reliable modality for the evaluation of the real extent of necrosis and has prognostic value in the assessment of HCC.
机译：背景：在肝细胞癌（HCC）治疗1个月后使用第二代造影剂进行的超声造影（CEUS）在描绘残余肿瘤方面几乎与对比增强计算机断层扫描（CECT）一样敏感。然而，术后早期行CEUS的有效性仍存在争议。目的：我们评估了CEUS在无法切除的肝癌患者局部区域治疗后不久评估肿瘤反应的诊断准确性（DA）。方法：本研究纳入94例104处肝癌患者，他们计划接受经皮乙醇注射、射频消融、经导管动脉化疗栓塞或联合治疗。以术后1个月的CECT为参考标准，术后48小时进行CEUS的DA检查。对患者进行随访，观察肿瘤或疾病进展情况。结果：根据CECT检查结果，104个病灶中有43个在术后1小时内被诊断为有残余生存能力？月CEUS在治疗48小时后检测到34/43个CECT治疗失败的结节中有残余肿瘤，其敏感性、特异性、阳性预测值、阴性预测值和准确度分别为79.1%、96.7%、94.4%、86.8%和89%。CEUS和CECT之间存在高度一致性（kappa系数=0.78）。在35个病灶中可检测到充血晕，一致性和不一致性病例之间无统计学显著差异。在非结节性疾病患者中，根据48小时CEUS，与无应答者相比，有应答者的平均总生存期和进展时间显著更长。结论：治疗48小时后进行的CEUS可以被认为是评估坏死真实程度的可靠方法，并且在评估HCC时具有预后价值。

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