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增强超声造影、磁共振弥散加权成像评价前列腺射频消融短期效果的实验研究
Contrast enhanced ultrasound and diffusion-weighted MR image evaluation of early changes after radiofrequency ablation in prostate in canine.

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DOI:
作者:
胡滨, 胡兵,陈磊, 李佳,黄瑾
Hu Bin, Hu Bing, Chen Lei, Li Jia, Huang Jin.
作者单位:
上海市第六人民医院超声医学科 上海交通大学附属第六人民医院病理科
Department of Ultrasound,Shanghai JiaoTong University Affiliated Sixth People’s Hospital Department of Pathology,Shanghai JiaoTong University Affiliated Sixth People’s Hospital
关键词:
前列腺，射频消融，超声造影，磁共振弥散加权显像，评价
Prostate; Radiofrequency ablation; Contrast Enhanced Ultrasound; Diffusion-Weight Magnetic Resonance Imaging; Evaluation
摘要:
目的：比较经直肠超声造影、磁共振弥散加权成像在前列腺射频消融术后短期内评估的有效性。方法对5例犬行前列腺两侧叶行射频消融，术后即刻行经直肠超声造影及MRI检查。MRI检查中以T2WI作为定位像，构建弥散加权成像图以及后续的表观弥散系数ADC图。比较两种技术所获得影像学特点。同时以病理学大体标本为标准，评估两种方法的影像学结果的准确性。结果：在射频消融后，超声造影可清晰地显示前列腺消融灶的范围，所测得的消融灶体积值与病理大体测值结果无明显统计学差异（P>0.05）。T2WI显示消融灶较为困难，DWI结果显示所有5例射频灶部位呈现略低信号，同时周围有明显环形高信号围绕，与周围正常前列腺组织分界较为清晰。ADC图中可发现，中央灶ADC值低于正常组织，周围环形带的ADC值在所有前列腺组织中最低。若将中央灶及环形带的区域作为ROI区域进行包括，其获得的体积大小与病理学标本无显著差异（P>0.05）.但仅计算中央灶体积，其大小显著低于实际标本大小（P<0.05）。结论：经直肠超声造影和磁共振弥散加权成像均能够反映前列腺射频消融术后短期内消融组织变化特点，但增强超声技术更简便，且相对准确性更高，适合做为射频消融后短期内评估的首选方法。
Objective To compare the efficiency of evaluating the early changes after radiofrequency ablation(RFA) in prostate in canine model by using contrast enhanced ultrasound and diffusion-weighted MR image (DWI).Methods： 5 male beagle dogs underwent RFA in the prostate. We created a lesion in the right and left lateral lobes of canine prostate respectively. Examination of contrast enhanced ultrasound and MR imaging were performed immediately after RF procedure. During the MRI examination, we constructed the DWI and ADC image based on the T2WI .Then, all animals were sacrificed and the prostates were harvested for pathologic analysis. Calculated thermal lesion volumes on contrast-enhanced ultrasonography and DWI were compared with volumes obtained from the pathological specimens. Results:Contrast enhanced ultrasonography can accurately visualize and verify the area of coagulative necrosis as documented at histology. There were no statically significant differences between average lesion volume on contrast enhanced ultrasound and gross view (P>0.05).In DW image, a relative low signal area could be noticed in the centre of radiofrequency area, which the ADC signal is relative high. Meanwhile, a high signal band located around the centre area, which the ADC signal was low. If the region of interest (ROI) concluded the centre area and rounded band, the volume of radiofrequency ablation in DWI was similar to the gross view(P>0.05). While, the measured area would be obvious small, if the ROI only concluded the centre area. Conclusion Both contrast-enhanced ultrasonography and DWI can be used to assess the RF lesion of prostate in early phase However, it seemed that the image obtained from the enhanced contrast ultrasound was more accurate than that obtained from the DW.We preferred that the enhanced contrast ultrasound should be the first choice in evaluating the radiofrequency ablation site in early phase.

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