| BackgroudLiver cancer is one of the common malignant tumors and it has significant morbidity and mortality,the incidence rate is the fourth in China,but its mortality rate is second.Radiofrequency ablation is widely used to crue liver cancer,incomplete ablation local recurrence are the main factors affecting the effect of RFA.To evaluate the effect of RFA accurately,detect incomplete ablation and local recurrencein time and give supplementary therapas early as possible are the key points to improve the curative effect.Iconography is the common way to be used to evaluate the effect of RFA,to evaluate the curative effect,ablation and recurrencein after RFA.ObjectiveCompare the effects of contrast-enhanced ultrasound(CEUS)and magnetic resonance scanning(MRI)in evaluating the effect of liver cancer RFA,in order to detect incomplete ablation or local recurrence in patients in time,and obtain the best imaging method for evaluating the efficacy of liver cancer RFA.MethodsFrom January 2018 to June 2019,146 patients(146 lesions)with liver cancer undergoing RFA in the Department of hepatobiliary surgery,the First Affiliated Hospital of Xinxiang Medical College,were selected as the research objects.All were followed up for1 years with contrast-enhanced ultrasound and magnetic resonance scanning to observe the residual and recurrence of the lesions : The initial re-examination was performed one month after the operation with contrast-enhanced ultrasound and magnetic resonance scanning to confirm whether there is residual disease,and then follow-up re-examinationonce every 3 months to observe whether there is tumor recurrence.Follow-up for 1consecutive years.Two experienced physicians in the imaging department of our hospital jointly completed the contrast-enhanced ultrasound and magnetic resonance reading and diagnosis.Comprehensive clinical diagnosis(combined with laboratory examination,CT enhancement and pathological results)was used as the "gold standard",and the two examinations were compared and analyzed The value of the method in the evaluation of the curative effect of liver cancer after RFA..ResultsAfter 1 years of follow-up,118 of the 146 lesions in 146 patients were completely ablated,accounting for 80.82%;28 incomplete ablation of lesions,accounting for 19.18%,of which 6 remained and 22 metastatic and recurrent lesions.CEUS of 146 lesions showed complete ablation of 122,accounting for 83.56%,24 remaining lesions,accounting for16.44%;MRI showed complete ablation of 116 lesions,accounting for 79.45%,and 30 remaining lesions,accounting for 20.55%.See Table 2.Taking comprehensive diagnosis as the "gold standard",the sensitivity,specificity,positive predictive value,negative predictive value,and accuracy of CEUS were 71.43%,96.61%,83.33%,93.44%,91.78%,and the consistent Kappa value was 0.725.See Table 3.The sensitivity,specificity,positive predictive value,negative predictive value,and accuracy of MRI examination were85.71%,94.92%,80.00%,96.55%,93.15%,respectively,and the consistency Kappa value was 0.725.The results of CEUS and MRI in 112 complete ablation lesions and 20 residual lesions were consistent.The Mc Nemar test showed that the difference was not statistically significant(=0.389,P>0.05).The positive of either CEUS or MRI was considered positive.The combined detection of the two showed 118 complete ablation and 28 residual lesions.The diagnostic sensitivity,specificity,positive predictive value,negative predictive value,and accuracy rates were 91.67% and 95.08 respectively.%,78.57%,98.31%,94.52%,and the consistent Kappa value is 0.814.ConclusionCEUS Group,MRI Group and DWI Group to evaluate the effect of RFA have its own advantage,but none of them can judge residual lesions after RFA,to choose the suitably imaging way and time by individual differences.The detecting tumor markers combined with follow-up can accurate prompt detecte the remaining lesions to achieve satisfactory effects. |
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