Assessment of radiofrequency ablation margin by MRI-MRI image fusion in hepatocellular carcinoma
Assessment of radiofrequency ablation margin by MRI-MRI image fusion in hepatocellular carcinoma
复制标题
MRI-MRI图像融合评估肝细胞癌射频消融边界
DOI：
10.3748/wjg.v21.i17.5345
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发表时间：
2015-05-07
影响因子：
4.3
通讯作者：
Zheng, Rong-Qin
中科院分区：
文献类型：
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作者：
Wang, Xiao-Li;Li, Kai;Zheng, Rong-Qin
目的：探讨磁共振成像(MRI)-MRI影像融合评估肝细胞癌（HCC）消融边缘（AM）的可行性及临床价值。方法：采用新开发的MRI-MRI影像融合超声工作站对52例HCC射频消融（RFA）后62个肿瘤的AM进行评价。病变分为两组：A组，肿瘤完全消融，AM达到5 mm (n = 32)；B组肿瘤完全消融，但未达到5 mm AM （n = 29）。为了检测局部肿瘤进展（LTP），所有患者在RFA后的第一年每两个月接受一次超声造影、MRI造影或CT检查。然后，随访时间延长至第一年之后的每三个月一次。结果：62例肿瘤中，MRI-MRI影像融合成功61例（98.4%）；其余1例术后肝脏明显变形，大量腹水。创建图像融合和AM评估所需的时间分别为15.5 +/- 5.5 min（范围：8-22 min）和9.6 +/- 3.2 min（范围：6-14 min）。随访时间1-23个月（14.2 +/- 5.4个月）。A组32例病灶未检出LTP， B组29例病灶中4例检出LTP，分别发生于RFA后2、7、9、15个月。B组LTP发生率（13.8%;4/29）显著高于A组（0/32,P = 0.046）。所有ltp都发生在未实现5毫米AM的区域。结论：超声工作站MRI-MRI图像融合评价肝细胞癌RFA后AM是可行的。
AIM: To investigate the feasibility and clinical value of magnetic resonance imaging (MRI)-MRI image fusion in assessing the ablative margin (AM) for hepatocellular carcinoma (HCC).METHODS: A newly developed ultrasound workstation for MRI-MRI image fusion was used to evaluate the AM of 62 tumors in 52 HCC patients after radiofrequency ablation (RFA). The lesions were divided into two groups: group A, in which the tumor was completely ablated and 5 mm AM was achieved (n = 32); and group B, in which the tumor was completely ablated but 5 mm AM was not achieved (n = 29). To detect local tumor progression (LTP), all patients were followed every two months by contrast-enhanced ultrasound, contrast-enhanced MRI or computed tomography (CT) in the first year after RFA. Then, the follow-up interval was prolonged to every three months after the first year.RESULTS: Of the 62 tumors, MRI-MRI image fusion was successful in 61 (98.4%); the remaining case had significant deformation of the liver and massive ascites after RFA. The time required for creating image fusion and AM evaluation was 15.5 +/- 5.5 min (range: 8-22 min) and 9.6 +/- 3.2 min (range: 6-14 min), respectively. The follow-up period ranged from 1-23 mo (14.2 +/- 5.4 mo). In group A, no LTP was detected in 32 lesions, whereas in group B, LTP was detected in 4 of 29 tumors, which occurred at 2, 7, 9, and 15 mo after RFA. The frequency of LTP in group B (13.8%; 4/29) was significantly higher than that in group A (0/32, P = 0.046). All of the LTPs occurred in the area in which the 5 mm AM was not achieved.CONCLUSION: The MRI-MRI image fusion using an ultrasound workstation is feasible and useful for evaluating the AM after RFA for HCC.