| Objective:(1) To study the effect of HCC tumor internal blood perfusion on its microwave ablation temperature range and ablation size;(2) To study the effect of HCC tumor peritumoral blood flow on its microwave ablation temperature range.Materials and Methods:1.39 HCC lesions were given CEUS examination and applied SonoLiver CEUS quantitative analysis software to receive related TIC and CEUS parameters. Tumor lesions were divided into 2 groups (low-perfusion group and high-perfusion group) according to their AUC values. Researching microwave ablation treatment was performed with a continuous power output of 50W, and time per lesion of 300s. In the 300s of researching ablation, two-point temperature was monitored. CEUS was performed after 300s researching ablation to measure the size of the ablated zone. Compare the temperature parameters of the internal front temperature area (A point: 0.4cm beside the antenna radiate point) and the internal latter temperature area (C point:backward 1.5cm to A point) of each group within 300s. Explore the relationship of tumor internal AUC values and ablation size.2.117 HCC lesions were given CEUS examination and applied SonoLiver CEUS quantitative analysis software to select AUC<5000 lesions for a total of 47.29 lesions were selected through assessment of CDFI by the enter criterion of vascular. 29 tumor lesions were divided into 2 groups (artery group and portal vein group) according to their peritumoral vascular using CDFI and PW technology. In the 300s of ablation, one-point temperature was monitored. Compare within-300s temperature parameters of each group. Explore the relationship of tumor external blood perfusion and temperature parameters.Results:1. (1) There was no statistical difference between low-perfusion group and high-perfusion group in the front temperature area (A point) of the internal tumor in five parameters-the peak temperature (Tmax), the maximum temperature difference (△Tmax), the average rate of change of temperature (Tarc), the mean temperature (Tmean), the median temperature (Tmid);(2) Tmax, △Tmax, Tarc, Tmean and Tmid of high-perfusion group and low-perfusion group in the latter temperature area (C point) of the internal tumor had statistical differences. Tmax, △Tmax, Tarc, Tmean and Tmid of the latter temperature area (C point) of the internal tumor in high-perfusion group were lower than low-perfusion group;(3) The short-axis diameter (SAD), the long-axis diameter (LAD) and volume (V300s) after 300s ablation demonstrated converse linear correlations with AUC. Their correlations were y=-7.249* 10-5x+3.521 (r=-0.566, P< 0.05), y=-1.17*10-4x+6.028 (r=-0.661, P< 0.05), y=-2*10-3x+56.798 (r=-0.785, P< 0.05) respectively. Every 10,000 units change in AUC, the three parameters reversely changed (0.725±0.355) cm, (1.17±0.44) cm, (24.995±6.575) cm3 respectively.2. (1) Tmax, △Tmax, Tarc, Tmean and Tmid of peritumoral vascular of artery group and portal vein group had statistical differences. Tmax, △Tmax, Tarc, Tmean and Tmid of peritumoral vascular of portal vein group were lower than that of the arterial group;(2) The blood volume of portal vein group demonstrated converse correlations with relevant Tmax, △Tmax, Tare, Tmean, and Tmid;(3) The blood volume of arterial group demonstrated converse correlations with relevant Tmax, △Tmax, Tarc, Tmean, and Tmid.Conclusions:1. (1) AUC value gotten from TIC of CEUS could represent tumor internal blood perfusion in study of "heat sink" effect on HCC microwave ablation;(2) HCC lesion internal perfusion had "heat sink" effect on microwave ablation;(3) HCC lesion internal front-field (beside the antenna radiate point) temperature had little effect on its internal perfusion, HCC lesion internal latter-field (away from the antenna radiate point) temperature had obvious effect on its internal perfusion, we should pay attention to this characteristic in clinical applications in case of ignoring incompletion thermal of the latter temperature area;(4) In the situation where other conditions (radiation power, time, peritumoral blood flow, et al) were fixed, the short-axis diameter (SAD), the long-axis diameter (LAD) and volume (V300s) of HCC lesion ablation zone had reverse linear correlation with internal tumor lesion perfusion.2. (1) Blood flow parameters gotten from CDFI could represent HCC peritumoral vessels perfusion in study of "heat sink" effect on HCC microwave ablation;(2) The "heat sink" effect on HCC microwave ablation of portal vein was stronger than that of the arteries of the same grade;(3) In the situation where other conditions (radiation power, time, tumor internal perfusion, et al) were fixed, the temperature parameters had converse correlation with HCC peritumoral vessels perfusion. |
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