The Application Value Of Three Dimensional Contrast Enhanced Ultrasound In Diagnosis And Radiofrequency Ablation For Hepatocellular Carcinoma

Objective To understand the application value of three-dimensional ultrasonography in the diagnosis of hepatocellular carcinoma and assessment of the efficacy of liver cancer after radiofrequency ablation through the study.Methods (1)To be selected the First Affiliated Hospital of Kunming Medical University from2014February to2012February in22confirmed cases of liver cancer patients with33lesions underwent two dimensional ultrasonography and three dimensional ultrasonography.To be classified according to different examination methods for the two dimensional ultrasonography and three dimensional ultrasound contrast group. Comparison of the displaying rate of the two methods for three dimensional shape, tumor vascular space structure and space perfusion.(2)To be select the22patients with33lesions underwent three dimensional contrast-enhanced ultrasound scanning section, according to whether can clearly show the lesions, classified according to different sections as follows:right rib gap scanning group, the right subcostal scanning group, Xiphoid scanning group. Observation due to differences in lesion growth location decision sections are different, thus influence showed three dimensional morphology.(3)As the same observation sections of different using the above method, effects on the vascular space three dimensional contrast enhanced ultrasonography in architecture and space perfusion display.(4)For the22patients with33lesions underwent3D contrast enhanced ultrasound and two dimensional ultrasound examination, according to tumor size, according to the diameter of the tumor lines were grouped into R, R<3cm,3cm≤R<5cm, R≥5cm group. The two dimensional ultrasound contrast group was used as control group, analysis of the impact of three dimensional tumor ultrasound contrast group size on tumor vascular space structure and space perfusion display.(5)To be selected the radiofrequency ablation in15patients with17lesions underwent three dimensional contrast enhanced ultrasound and two dimensional contrast enhanced ultrasound examination from22HCC patients above confirmed, comparison of two methods for postoperative tumor detection rate.Results1.two-dimensional ultrasound tumor region of ROI credibility by linear regression analysis, R=0.88, results with high reliability.2.The tumors showed three dimensional form, tumor vascular space structure and space perfusion rate selection rank sum test. Tumors of the three dimensional contrast enhanced ultrasound and two dimensional contrast enhanced ultrasound angiography showed there were significant differences (P<0.05).3.The three dimensional form of tumors display rate with rank sum test. Scan in the right costal margin, right intercostal space, xiphoid, three dimensional shape of tumor showed a statistically significant difference (P<0.05).4.The framework and space perfusion of tumor vascular space display rate with rank sum test. Scan in the right costal margin, right intercostal space, xiphoid, vascular space structure and space perfusion of the tumor showed there were significant differences (P<0.05).5.The framework and space perfusion of tumor vascular space display rate with rank sum test(1) The largest tumor diameter R<3cm, three dimensional imaging and two dimensional imaging angiography showed no significant difference (P>0.05).(2)3cm<R<5cm, two kinds of ultrasonic angiography showed there were significant differences (P<0.05).(3) R>5cm, two kinds of contrast method showed significant difference (P<0.05).6.Has been undergoing radiofrequency catheter ablation of HCC lesions, vascular number of lesions by rank sum test, three dimensional contrast enhanced ultrasound and two dimensional contrast enhanced ultrasound showed significant differences in tumor after operation (P<0.05).Conclusion1.Two dimensional contrast enhanced ultrasound is a sophisticated imaging methods, but it can not show the three dimensional morphology,vascular space structure and space perfusion of tumor. Three dimensional contrast enhanced ultrasound imaging can provide these two aspects of tumor imaging information for clinicians.2.Tumor three dimensional morphology, vascular space structure and space perfusion display are affected by the scan plane. In the right intercostal space and right subcostal scan could clearly show the lesions, the image quality is better than that of Xiphoid scanning section.3.Through the comparison of three dimensional contrast enhanced ultrasound with two dimensional contrast enhanced ultrasound, vascular space architecture and space perfusion of tumor display affected tumor size to a great extent, the largest lesion diameter line R≥3cm, can clearly display the lesion vessels. The author thinks that the growth location of tumor and size of tumor are two important factors affecting the three dimensional image quality.4.Current the three dimensional contrast enhanced ultrasound technology is not yet mature. It does not apply to display the tumors maximum diameter R<3cm, and it was lacked of analysis of time intensity curve, the peak time, the credibility of the quantitative data of software, still need more development.5.For the patients who had liver cancer was accepted the radiofrequency ablation, three dimensional contrast enhanced ultrasound can display the number of tumor vascular good postoperative.