Contrast-enhanced ultrasound guided radiofrequency ablation for conventional ultrasound negative recur-rent hepatocellular carcinoma:analysis of the recent therapeutic efficacy / 实用医学杂志

ABSTRACT

Objective To investigate the short-term curative effect of radiofrequency ablation(RFA)in patients with conventional ultrasound negative(CUN)recurrent hepatocellular carcinoma(RHCC)under Contrast-enhanced ultrasound(CEUS). Methods Between January 2013 and March 2017,conventional ultrasound nega-tive RHCC patients in 108 cases of 113 lesions who underwent percutaneous transhepatic RFA guided by CEUS in our Hospital ultrasound department. All cases were characterized by Contrast-enhanced CT/MRI and detected by CEUS in the corresponding position. According to CEUS arterial phase to strengthen the maximum diameter of the group,the largest diameter ≤ 3 cm for the N1 group,> 3 cm for the N2 group. Conventional ultrasound positive (CUP)RHCC patients in 88 cases of 94 lesions who underwent percutaneous transhepatic RFA guided by conven-tional ultrasound were selected as the control group(CUP group).All lesions were treated with RFA prior to CEUS examination.CEUS/CECT/MRI were reviewed at 1 month,3 months and 6 months after RFA,and the short-term efficacy was evaluated after RFA. Results There was no significant difference in the efficacy of RFA between 1 month,3 months and 6 months(P=0.75,P=0.85,P=0.41)between CUN group and CUP group.Comparison of short-term curative effect between N1 group and N2 group.There was significant difference within 6 months after RFA(P<0.001).There was significant difference at 3 months and 6 months after RFA(P=0.033,P=0.001), and there was no significant difference at 1 months after RFA(P=0.123).Analysis of ROC curve of CUN group′s maximum diameter and RFA short-term curative effect,the optimal cutoff value was 2.95 cm,and the area under the cutoff curve(AUC)was 0.90,the sensitivity was 92.3%,and the specificity was 84.0%. Conclusion CEUS can accurately locate and guide,especially at which the maximal diameter 3cm lesions inconventional ultrasound negative RHCC radiofrequency ablation. The lesions which are more than 3cm is needed to use multi-electrode RAF,which is limited by the strengthening time,and the accuracy of Electrodes were deployed decreased,it is not easy to ensure that the ablation area between the effective overlap ablation. Postoperative review can be found in a timely manner recurrence of residual lesions,which demonstrates that the sooner the treatment effect is more ideal.