Value of contrast-enhanced ultrasound in the evaluation of local residual and recurrence in liver cancer patients after microwave ablation treatment
Objective To investigate the value of contrast-enhanced ultrasound(CEUS)in the evaluation of local re-sidual and recurrence in liver cancer patients after microwave ablation(MWA)treatment.Method A total of 86 liver cancer patients who received MWA treatment were selected,all patients underwent CEUS examination before surgery and one month after surgery.Using the clinical comprehensive diagnosis results as the gold standard,the evaluation value of CEUS for local residual in liver cancer patients after MWA treatment was analyzed.Followed up for 1 year after sur-gery,patients were divided into recurrence group(n=27)and non-recurrence group(n=59)according to the recurrence sit-uation.The clinical characteristics of the two groups were compared,and the influencing factors of recurrence in liver cancer patients after MWA treatment were analyzed by Logistic regression model.The receiver operating characteristic(ROC)curve was plotted,the area under the curve(AUC)was calculated,and the value of peak intensity(PI)and time to peak(TTP)single and combined detection in evaluating the recurrence of liver cancer patients after MWA treatment were analyzed.Result Clinical comprehensive diagnosis results showed that among the 117 lesions,91 were completely ablat-ed and 26 were locally residual;the results of CEUS showed that 87 were completely ablated and 30 were locally residu-al.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of CEUS in evaluating the local residual of liver cancer patients after MWA treatment were 84.62%,91.21%,89.74%,73.33%,95.40%,respectively.The proportion of patients with unclear boundaries,irregular shape and tumor maximum diameter>3 cm and the PI in the recurrence group were higher than those in the non-recurrence group,and the TTP and arrival time(AT)were shorter than those in the non-recurrence group,and the differences were statistically significant(P<0.05).Multivariate Logistic regres-sion analysis showed that maximum tumor diameter>3 cm and the increase of PI were independent risk factors for recur-rence of liver cancer patients after MWA treatment(P<0.01),and the increase of TTP was an independent protective fac-tor for recurrence of liver cancer patients after MWA treatment(P<0.01).The ROC curve showed that the AUC,sensitivi-ty and specificity of PI and TTP combined detection in evaluating recurrence of liver cancer patients after MWA treat-ment were higher than those of the single detection.Conclusion CEUS has high value in the evaluation of local residual and recurrence in liver cancer patients after MWA treatment,and is worthy of clinical application.
contrast-enhanced ultrasoundliver cancermicrowave ablationlocal residualrecurrenceevaluation value
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