CAJ | 학술논문

目的探讨剪切波弹性成像(shear wave elastography,SWE)评价不同消融条件下离体猪肝组织射频消融(radiofrequency ablation,RFA)灶硬度变化和消融气体对弹性成像的影响.方法新鲜离体猪肝12只共24块,随机分为4组,每组6块.分别予以RFA 6 min、12 min、无水酒精15 ml注射联合RFA 6 min、无水酒精15 ml注射联合RFA 12 min,测定并比较消融前、消融后气体未消除时、消融后气体消除时猪肝消融区杨氏模量.结果 SWE图清晰显示消融区域硬度变化范围,且二维声像图中强回声气体后方声衰减部分得到显示.消融前、消融后气体未消除时、消融后气体消除时的杨氏模量分别为(14.90±4.04) kPa、(94.31±23.03) kPa、(89.32±20.77) kPa,消融后气体未消除时、消融后气体消除时杨氏模量分别与消融前杨氏模量比较差异具有统计学意义(P ＜0.001、P＜0.001),消融后气体未消除时杨氏模量与消融后气体消除时杨氏模量比较差异无统计学意义(P=0.385).RFA 6 min、12 min、无水酒精15 ml注射联合RFA 6 min、无水酒精15 ml注射联合RFA 12 min消融前后杨氏模量改变分别为(81.29±9.19)kPa、(84.88±9.89)kPa、(97.27±16.20)kPa、(103.82±22.04)kPa,是否联合无水酒精注射对射频消融前后杨氏模量变化影响差异具有统计学意义(P =0.009),而射频消融持续时间的不同对消融前后杨氏模量变化影响差异无统计学意义(P=0.275).结论 SWE几乎能够不受气体影响定量分析离体猪肝射频消融灶硬度变化,且不同消融条件的杨氏模量变化有所不同.
목적 탐토전절파탄성성상(shear wave elastography,SWE)평개불동소융조건하리체저간조직사빈소융(radiofrequency ablation,RFA)조경도변화화소융기체대탄성성상적영향.방법 신선리체저간12지공24괴,수궤분위4조,매조6괴.분별여이RFA 6 min、12 min、무수주정15 ml주사연합RFA 6 min、무수주정15 ml주사연합RFA 12 min,측정병비교소융전、소융후기체미소제시、소융후기체소제시저간소융구양씨모량.결과 SWE도청석현시소융구역경도변화범위,차이유성상도중강회성기체후방성쇠감부분득도현시.소융전、소융후기체미소제시、소융후기체소제시적양씨모량분별위(14.90±4.04) kPa、(94.31±23.03) kPa、(89.32±20.77) kPa,소융후기체미소제시、소융후기체소제시양씨모량분별여소융전양씨모량비교차이구유통계학의의(P ＜0.001、P＜0.001),소융후기체미소제시양씨모량여소융후기체소제시양씨모량비교차이무통계학의의(P=0.385).RFA 6 min、12 min、무수주정15 ml주사연합RFA 6 min、무수주정15 ml주사연합RFA 12 min소융전후양씨모량개변분별위(81.29±9.19)kPa、(84.88±9.89)kPa、(97.27±16.20)kPa、(103.82±22.04)kPa,시부연합무수주정주사대사빈소융전후양씨모량변화영향차이구유통계학의의(P =0.009),이사빈소융지속시간적불동대소융전후양씨모량변화영향차이무통계학의의(P=0.275).결론 SWE궤호능구불수기체영향정량분석리체저간사빈소융조경도변화,차불동소융조건적양씨모량변화유소불동.
Objective To evaluate the stiffness of porcine liver in vitro treated with the radiofrequency ablation (RFA) using shear wave elastography (SWE).Methods A total number of 24pieces of porcine livers were randomly divided into 4 groups,which were treated with RFA for 6 min or 12 min,and 15 ml ethanol injection combined with RFA for 6 min or 12 min,respectively.The Young modulus were measured before ablation,after ablation immediately and 30 min after ablation when the gas disappeared in ablation zone.Results SWE imaging can clearly delineate the boundary of the stiffness changes in the RFA ablation zone,even that part was difficult to display in baseline ultrasound due to the gas hyperechogenicity reflection.The mean Young modulus before ablation、after ablation immediately and 30 min after ablation without gas reflection were (14.90 ± 4.04) kPa,(94.31 ± 23.03) kPa,(89.32 ± 20.77) kPa,respectively.Both the mean Young modulus of after ablation immediately and 30 min after ablation were significantly different from that of before ablation (P ＜ 0.001,P ＜ 0.001),but there was no significant difference between the mean Young modulus of after ablation immediately and 30 min after ablation (P =0.385).The Young modulus changes of ablation zone of RFA 6 min,12 min,15 ml ethanol injection combined with RFA 6 min or 12 min were (81.29 ± 9.19) kPa,(84.88 ± 9.89)kPa,(97.27 ±16.20)kPa,(103.82 ± 22.04)kPa,respectively.The ethanol injection combined with RFA could make the ablation zone stiffer than only RFA did (P =0.009),whereas prolonging ablation duration would make no change of stiffness in ablation zone (P =0.275).Conclusions SWE can quantitatively monitor the elasticity changes of porcine liver during RFA treatment in vitro,no matter the gas exists in the ablation zone or not.The changes of stiffness in ablation zone were different when ethanol was injected pre-ablation.