采用三维超声造影和自动配准技术快速判断肝癌消融效果的应用基础研究

项目名称： 采用三维超声造影和自动配准技术快速判断肝癌消融效果的应用基础研究

项目编号： No.81501493

项目类型： 青年科学基金项目

立项/批准年度： 2016

项目学科： 医药、卫生

项目作者： 黄光亮

作者单位： 中山大学

项目金额： 18万元

中文摘要： 肝细胞癌是我国的常见病和多发病。外科切除是公认治疗肝细胞癌的首选方法。由于大多数患者常伴有肝硬化，肝功能差，仅有30%左右的患者能够获得手术机会。目前，射频消融已经广泛应用于肝细胞癌的非手术治疗，并取得较好的疗效。但是由于消融范围有限，治疗中、大肝癌需要多次穿刺、消融过程中产生的气体会干扰二次进针，增加穿刺的不确定性，导致消融位置不准确和消融范围不规则，难以及时准确判断安全边缘及治疗效果。增强CT或MR被公认为判断肿瘤是否完全消融的金标准，但是射频消融后1月内病灶周围的肝实质容易产生炎症充血性反应，难与肿瘤残留鉴别开来。为了精准地进行肿瘤消融和疗效判断，本研究拟在消融前后进行肝脏肿瘤快速三维超声造影成像，应用自动配准技术和多平面重建技术，比较病灶与消融灶的空间立体结构，精确计算出肿瘤的安全消融边缘从而准确判断病灶的消融效果

中文关键词： 肝细胞癌；射频消融；超声造影；疗效评估；自动配准

英文摘要： Hepatocellular carcinoma (HCC) is a common disease in our country. Surgical resection is recognized as the preferred method of treatment of HCC. Since most patients often accompanied by cirrhosis, liver dysfunction, only about 30% of the patients were able to receive the surgical treatment. Currently, radiofrequency ablation has been widely used in non-surgical treatment of hepatocellular carcinoma and has obtained good prognosis. Due to the limited extent of coagulation necrosis, the treatment of medium and large HCC require multiple puncture. Gases generated during ablation will interfere in the subsequence needle puncture which caused the uncertainty of puncture, resulted in inaccurate ablation position and irregular ablation area. It is difficult to timely and accurately determine the safety margin and therapeutic efficacy of the tumor. Contrast-enhanced CT or MR is considered to the gold standard method to determine whether the tumor is complete ablation. due to the surrounding liver parenchymal prone to inflammatory congestive reaction within one month after ablation, it is sometimes difficult to discriminate from residual tumor. In order to accurately ablate the tumor and determine the treatment efficacy, three-dimensional contrast-enhanced ultrasound imaging before and after ablation of liver tumors will be performed to compare the relationship of the three-dimensional structure of lesion with that of ablated area, accurately calculate the safety margin of the tumor, and accurately determine the treatment outcome with the application of automatic registration technique and multi-planar technique.

英文关键词： hepatocellular carcinoma;radiofrequency ablation;contrast enhanced ultrasound;treatment outcome evaluation;automatic registration