The Study Of Contrast-enhanced Ultrasound In The Evaluation Of The Therapeutic Effect Of Microwave Ablation For Hepatic Alveolar Echinococcosis

Objective: Used the contrast-enhanced ultrasound imaging technology to observe the changes in imaging characteristics of early hepatic alveolar echinococcosis before and after microwave ablation,and analyze the relevant parameters,to evaluate the efficacy of microwave ablation in the treatment of hepatic alveolar echinococcosis.Methods: The patients who were diagnosed as hepatic alveolar echinococcosis and received microwave ablation in the affiliated Hospital of Qinghai University from June 2019 to July 2020 were examined by contrast-enhanced ultrasound before microwave ablation.The maximum diameter of hepatic alveolar echinococcosis lesions was measured,the contrast-enhanced ultrasound patterns of lesions and marginal infiltrating zones were observed,and the contrast-enhanced parameters were analyzed.Contrast-enhanced ultrasound was performed at 3 days,3months,6 months and 12 months after operation.the changes of the maximum diameter of all lesions,the contrast enhancement mode of lesions and their marginal infiltrating zones and the PI values of contrast parameters were recorded in detail at 3days,3 months,6 months and 12 months after operation.the changes of the above observed indexes were compared and analyzed.And all the patients were examined by plain scan CT at the same time,and the changes of the maximum diameter and calcification of all lesions at the same level in each time period were compared and analyzed.Results: 1.A total of 45 patients with 45 lesions were collected.The follow-up data were completed in 26 cases and lost in 19 cases.2.The maximum diameter of all lesions(45 lesions)measured by conventional ultrasound before operation was significantly different from that measured by contrast-enhanced ultrasound(P < 0.001).For the 26 lesions with completed case data,there was significant difference in the maximum diameter of lesions measured by contrast-enhanced ultrasound before operation,3 days,3 months,6 months and 12 months after operation(P < 0.001).There was significant difference in the maximum diameter between preoperative and postoperative 3 days,6 months and 12 months(P< 0.05),but there was no significant difference between preoperative and postoperative 3 months(P > 0.05).At 3 months,6 months and 12 months after operation,the maximum diameter of the lesion decreased gradually.3.The interior of all lesions(45 lesions)showed no enhancement pattern in three phases before operation,19(42.2%)lesions showed uniform annular hyperenhancement in arterial phase,and 26(57.8%)lesions showed inhomogeneous nodular hyperenhancement in arterial phase.and showed a "fast in and slow out" enhancement mode.4.The Pi values of preoperative marginal infiltration zone and normal liver tissue in 45 lesions were(100.29 ±21.92)db and(70.16 ±26.85)db,respectively(P < 0.001).Postoperative follow-up showed that the Pi value at the edge of the ablation focus in a few patients was higher than that in the adjacent normal liver tissue.5.Among the 26 lesions with complete data,the maximum diameter measured by plain-scan CT at 3days,3 months,6 months and 12 months after operation was significantly different among many groups(P < 0.001).There was no significant difference between pre-operation and 3 months after operation(P < 0.05),but there was significant difference between pre-operation and 3 days,6 months and 12 months after operation(P < 0.05).The proportion of increased calcification of the above 26 lesions 3 days,3months,6 months and 12 months after operation by plain scan CT was 0%(0),19.2%(5),53.8%(14)and 80.7%(21),there are significant differences in comparison.Conclusion: Contrast-enhanced ultrasound is of great significance in the evaluation of the effect of microwave ablation for the early hepatic alveolar echinococcosis.Ultrasound-guided percutaneous microwave ablation of the liver is an effective way to treat the early hepatic alveolar echinococcosis.Contrast-enhanced ultrasound combined with plain-scan CT can better evaluate the clinical efficacy of microwave ablation in the treatment of early early hepatic alveolar echinococcosis.