The Value Of The Application Of Quantitative Parameters Of Contrast-enhanced Ultrasonography Combining With Time-intensity Curve In Assessing Therapeutic In Microwave Ablation Of Primary Liver Cancer

Objective:(1)To study the difference of the quantitative parameters of the time-intensity curve(TIC)with surrounding normal liver parenchyma in before and after microwave ablation of primary liver cancer;(2)To analyze the diagnostic efficacy of CEUS combined with TIC for the ablation efficacy.The aim is to objectively and accurately evaluate the ablation efficacy of primary liver cancer by quantitative data,find residual or recurring lesions as soon as possible,formulate treatment plans as soon as possible,and maximize the survival time of patients and improve the quality of life of patients.Methods:75 patients with clinically diagnosed primary liver cancer whounderwent microwave ablation under the guidance of ultrasound were selected from April 2019 to June 2020,with a total of 82 nodules.Among them,69 patients had only a lesion,five patients had two lesions,and a patient had three lesions.There were 66 men and nine nine women,with a mean age of 56.7±9.6 years,range 38-72 years.For all the included lesions,CEUS was performed before ablation,and TIC was generated at the same time.CEUS was performed immediately after ablation,and TIC was generated at the same time.Routine US examination and CEUS were performed at a month,three months and six months after ablation,and TIC was generated at the same time.The results were based on at least two kinds of enhanced imaging examinations,including CEUS,enhanced CT(CECT)and enhanced magnetic resonance(CEMRI),and combined with relevant laboratory examinations or pathological results.(1)To compare the quantitative parameters of TIC of the lesions before ablation,edema zone around ablation area after ablation,residual lesions a month after ablation,recurrent lesions three months and six months after ablation with those of the surrounding normal liver tissues.The quantitative parameters of TIC of the edema zone around ablation area,residual lesions a month after ablation,recurrent lesions three months and six months after ablation were compared with those of the lesions before ablation.(2)According to different diagnostic methods,the difference of diagnostic efficiency between CEUS group and CEUS combined TIC group was compared and analyzed.Result:(1)The time to peak(TTP)and the half of time to peak(DT/2)of the the lesions before ablation,residual lesions a month after ablation,recurrent lesions three months and six months after ablation were lower than those of normal liver parenchyma,and the difference was statistically significant.The ascending slope(AS)was higher than that of normal liver parenchyma,and the difference was statistically significant,The peak intensity(PI)was no significant difference between with the surrounding normal liver parenchyma.After ablation,TTP and DT/2 of edema zone around ablation area were lower than those of surrounding normal liver parenchyma,the difference was statistically significant,AS and PI were higher than those of surrounding normal liver parenchyma,the difference was statistically significant,meanwhile,It was no statistically significant difference in BI.the BI of residual lesions at a month,the recurring lesions at three and six month after ablation were greater than those before ablation,and the differences were statistically significant.It was no statistically significant difference in PI,TTP,AS and DT/2.The PI,DT/2 and TTP of the edema zone around the ablation zone were greater than those of the preoperative lesion tissue,and the difference was statistically significant.The difference in AS and BI was not statistically significant.(2)The sensitivity,accuracy and negative predictive value of CEUS combined with TIC group were higher than CEUS group in a month,three and six month after ablation,the difference was not statistically significant.Conclusion:When evaluating the efficacy of ultrasound-guided microwave ablation for primary liver cancer,the TTP and DT/2 of the local residual or recurring liver cancer lesions after microwave ablation are lower than those of the surrounding normal liver parenchyma,and the AS is greater than that of the surrounding normal liver parenchyma.Therefore,CEUS combined with TIC can quantitatively evaluate the nature of the lesions and make the results more accurate.