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A Study Of Contrast-Enhanced Ultrasound And Ultrasonic Tissue Characterization Before And After The Liver Cancer Treatment Using Microwave Or Radiofrequency Ablation

Posted on:2006-04-04Degree:DoctorType:Dissertation
Country:ChinaCandidate:X Y ChenFull Text:PDF
GTID:1104360155450720Subject:Medical imaging and nuclear medicine
Abstract/Summary:PDF Full Text Request
Objective: 1. To compare the contrast-enhanced ultrasound to the gray scale ultrasound and color Doppler flow imaging (CDFI), and thus evaluating the advantages of the new generation contrast agent (SonoVue) and the imaging software contrast pulse sequencing (CPS) in the diagnosis of hepatocellular carcinoma (HCC). 2. To evaluate the role of the new contrast agent (SonoVue) and the imaging software CPS, the real-time, non-destructive low mechanical index (MI) imaging in assessing the therapeutic response of percutaneous radiofrequency or microwave ablation in the patients with hepatocellular carcinoma. 3. To conduct quantitative analysis on the brightness (intensity) in the ultrasound images before and after the liver cancer treatment using microwave or radiofrequency ablation by using the ultrasonic tissue characterization (integrated backscatter IBS) technique, thus evaluating its practical value in assessing the therapeutic response of percutaneous radiofrequency or microwave ablation.Methods: 1. 15 patients with 20 hepatocellular carcinoma lesions that were diagnosed by surgery or biopsy were scanned by the Acuson Sequoia 512 Ultrasound system, the imaging software CPS, MI 0.19, and the contrast agent SonoVue. The 20 HCC lesions were examined with gray scale ultrasound, CDFI and CPS separately before and after treatment, so as to monitor the size, echo intensity, intratumoral vascularity of tumors and the perfusion of tumors parenchyma during the vascular phase and the therapeutic response after the treatment. The ultrasound findings were compared with the contrast-enhanced computer tomography (CECT) and the contrast-enhanced magnetic resonance imaging (CEMRI) findings. 2. With the help of the HP-SONOS5500 ultrasound system, 43 liver tumor lesions were evaluated withacoustic densitometry before and after the treatment of radiofrequency ablation (RFA) or microwave ablation (MVA). The ultrasonic integrated backscatter (IBS) and its changes were examined and compared in the tumors and the regions of interest (ROI) with the ultrasonic tissue characterization method before and after the treatment. The results were also compared with those of CECT or CEMRI so as to determine the effectiveness of ultrasonic tissue characterization.Results: 1. In HCC morphology, the imaging of contrast-enhanced ultrasound was similar to that of the gray scale ultrasound, but in the aspect of the diameter and areas of the tumor, contrast-enhanced ultrasound displayed greater results than the gray scale ultrasound did. There was significant difference between them (P<0.01). Contrast-enhanced ultrasound detected the liver lesions that gray scale ultrasound could not. Both ultrasounds revealed the vascularity and the perfusion of HCC, but the result of the contrast-enhanced ultrasound was significantly superior to that of CDFI (P<0.01). The enhancement pattern of HCC with contrast-enhanced ultrasound in the vascular phase was in correlation with the degree of cellular differentiation. 2. After the ablation treatment, the area did not enhance when the contract agent was administrated during arterial, venous phase and late phase. The enhancement pattern during arterial and venous phase between SonoVue enhanced CPS and CECT and/or CEMRI before and after ablation treatment were very similar. The therapeutic response of ablation couldn't be accurately observed by the gray scale ultrasound and CDFI. 3. With the ultrasonic tissue characterization method, the values of ultrasonic integrated backscatter were measured separately before and after the ablation treatment, and they showed significant difference. The IBS was also in correlation with the CECT and/or CEMRI.Conclusion: 1. CPS and SonoVue are real-time, effective approaches in revealing the intratumoral vascularity and the perfusion of HCC. The detection and characterization of HCC with the contrast enhanced ultrasound are superior to those of the gray scale ultrasound and CDFI. 2. The contrast-enhanced ultrasound with CPS may become another useful method that has high diagnostic agreement with CECT and/or CEMRI in assessing the therapeutic effect of RFA or MWA in hypervascular...
Keywords/Search Tags:Ultrasonography, Contrast agent, Liver tumor, Radiofrequency ablation, Microwave ablation, Ultrasonic tissue characterization, Integrated backscatter
PDF Full Text Request
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