Value Of Dynamic Three-dimensional Contrast-enhanced Ultrasonography In The Evaluation Of Percutaneous Radiofrequency Ablation Of Hepatic Tumors

Purpose:To investigate the value of dynamic three-dimensional contrast-enhanced ultrasound (3D-CEUS) in the evaluation of percutaneous radio frequency ablation (RFA) of hepatic tumors.Methods:48lesions were studied in48patients. All patients underwent2D-CEUS and35of them underwent3D-CEUS within a week before RFA. One and three month after ultrasound-guided RFA, color Doppler flow imaging, CEUS and contrast enhanced computed tomography (CECT) or contrast-enhanced magnetic resonance imaging (CEMRI) were performed to assess the therapeutic response. The use of biopsy or two or more imaging examination(ultrasound, CT, MR, nuclear medicine, PET) and tumor markers offered a-diagnostic standard of residual beyond3months follow-up after ablation.Results:1. Before RFA, the detection rate of tumor nourishing blood vessels of2D-CEUS and3D-CEUS was65.71%(23/35),100%(35/35),respectively, the difference was statistically significant(x2=14.48, p=0.000).2. Before RFA, dynamic3D-CEUS was superior to2D-CEUS in display of integrity and definition of blood vessel and spatial relationships of tumor, the difference was statistically significant(Z=-7.75,p=0.000).3.After RFA, Dynamic3D-CEUS increased confidence but made no change in management or diagnosis in36(75%) lesions,while made no change in12(25%).3D-CEUS did not change the diagnosis or clinical management in any patient compared with2D-CEUS.4. After RFA,40of48lesions were found no-enhancement in entire CEUS procedure, while8lesions showed local enhancement on the edge of lesion.39of48lesions showed no-enhancement and other9with irregular enhancement by CECT/MRI. According to the final diagnostic criteria based on Pathology or imaging results during Regular follow-up, the sensitivity of CEUS and CECT/MRI in detection of residual tumor was80%and80%, specificity was100%and97.4%,and accuracy was95.8%and93.8%, respectively. There was no statistical significance between CEUS and CECT/MRI.Conclusion:1. Dynamic3D-CEUS can effectively evaluate the nourishing blood vessels distribution of hepatic malignant tumors, provide more space information for disease diagnosis and interventional treatment, is an important complement of2D-CEUS.2. There was no statistical significance among3D-CEUS,2D-CEUS and CECT/MRI in the evaluation of percutaneous radiofrequency ablation of hepatic tumors.But3D-CEUS enhances the diagnostic confidence in the majority of the patients,3D-CEUS has potential usefulness in the evaluation of percutaneous radiofrequency ablation of hepatic tumors.