Application of contrast-enhanced ultrasound in the diagnosis of hepatocellular carcinoma and evaluation of the therapeutic efficacy of radiofrequency ablation
10.3760/cma.j.cn341190-20240605-00690
- VernacularTitle:超声造影在肝细胞癌诊断及射频消融治疗效果评估中的应用
- Author:
Xiao QIAN
1
;
Zhihui CHEN
;
Fangfang ZHOU
Author Information
1. 浙江中医药大学研究生院，杭州 310053
- Publication Type:Journal Article
- Keywords:
Carcinoma, hepatocellular;
Ultrasonography, doppler, color;
Angiography;
Catheter ablation;
Magnetic resonance imaging;
Disodium gadolinium selenate
- From:
Chinese Journal of Primary Medicine and Pharmacy
2025;32(3):326-330
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the application of contrast-enhanced ultrasound (CEUS) in the diagnosis of hepatocellular carcinoma (HCC) and evaluate the therapeutic efficacy of radiofrequency ablation.Methods:A case-control study was conducted among high-risk HCC patients who underwent puncture biopsies at Lishui Central Hospital from January 2019 to January 2023. A total of 118 confirmed HCC patients were selected as the case group, and 118 patients with hepatitis B cirrhosis were selected as the control group, following a 1:1 matching principle. All patients underwent a CEUS examination, and the therapeutic efficacy of CEUS in detecting HCC was analyzed. The case group underwent radiofrequency ablation for 1 month. The case group underwent 1 month of radiofrequency ablation treatment, and the application value of CEUS in assessing the efficacy of radiofrequency ablation for HCC was evaluated based on the results of Gd-EOB-DTPA-enhanced magnetic resonance imaging.Results:The results of the CEUS examination were compared with the pathological diagnosis results. In the case group, 6 cases were misdiagnosed, while in the control group, 8 cases were missed. The diagnostic accuracy of CEUS was 94.07%, and the Cohen's Kappa value for CEUS was 0.88, indicating a good consistency between CEUS and pathological diagnosis results. After radiofrequency ablation, the alpha-fetoprotein levels in the case group decreased significantly from [(141.27 ± 34.90) μg/L] before the procedure to [(59.78 ± 14.55) μg/L] after the procedure ( t = 24.32, P < 0.001). However, the longest diameter of the lesions increased from [(17.44 ± 4.17) mm] before the procedure to [(28.47 ± 5.41) mm] after the procedure ( t = -16.46, P < 0.001). There was no statistically significant difference in the longest diameter of the tumors assessed by CEUS postoperatively compared to the Gd-EOB-DTPA-enhanced MRI results ( P > 0.05). When comparing the efficacy of radiofrequency ablation assessed by CEUS to the results from Gd-EOB-DTPA-enhanced MRI, there were 8 true positive cases, 107 true negative cases, and 3 cases that were misdiagnosed. The accuracy of CEUS in assessing the efficacy of radiofrequency ablation for HCC was 97.46%, with a Cohen's Kappa value of 0.83. Conclusions:CEUS demonstrates a high accuracy in the diagnosis of HCC and can serve as an effective method for evaluating the efficacy of radiofrequency ablation. It shows good consistency with pathological diagnoses and Gd-EOB-DTPA-enhanced MRI results, indicating a high clinical application value.
