| PART I.Experimental study on repeatability of US-CT andUS-MR image fusionvolume navigation technologyObjective:Use the liver phantom to verify the repeatability of US-CT and US-MR image fusion volume navigation in clinical application.Methods:Three hepatic veins and several cyst models were included in the liver phantom.The three hepatic veins and cyst models were clearly visible in CT?MRimages and conventional ultrasound scanning.Two different experienced operators use different mode to performed three times of the image fusion process on the phantom at different times in one week individually and repeated the process one more time on the next week,and six cysts models were selected to record the fusion counterpoint rate for each time.Results:Both the high-and low-seniority operators can obtain high coincidence rate and low coefficient of variation when different image fusion methods are used.Whenusing US-CT image fusion technology,there was no significant difference in the image coincidence rate between the two operators in either the first experiment or the second experiment(the first experiment:p=0.152;The second experiment:p=0.116).There was no significant difference in the overlap rate between the first experiment and the second experiment(operator ?:p=0.390;Operator ?:p=0.201).Using US-MR image fusion technology,there was also no significant difference in the image coincidence rate between the two operators in either the first experiment or the second experiment(the first experiment:p=0.263;The second experiment:p=0.197).There was no significant difference in the overlap rate between the first experiment and the second experiment(operator ?:p=0.635;Operator ?:p=0.085).Conclusion:Both US-CT and US-MR image fusion volume navigation technology are feasible?repeatable and has the high accuracy,each can be used as an effective guidance method in the process of ultrasound interventional diagnosis and treatment.PART ?.A comparative study on the efficacy of US-MRI fusion imaging volume navigation technology and conventional ultrasound-guided microwave ablation of small liver cancerObjective:To evaluate the clinical value of US-MRI fusion volume navigation in the treatment of small liver cancer by microwave ablation.Methods:The study group selected 37 patients with liver cancer who were treated in our department from October 2015 to December 2017,with a lesions diameter less than 3cm.Among them,27 males and 10 females,with an average age of 58.All patients used ultrasound-magnetic resonance(US-MRI)fusion volume navigation technology to complete the local microwave ablation of liver cancer.The control group include 37 patients with liver cancer who were treated in our department from October 2015 to December 2017,with a lesions diameter also less than 3cm.Among them,30 males and 7 females,with an average age of 60.Patients in this group underwent microwave ablation of the tumor guided by ordinary ultrasound.CEUS was performed 30min after the surgery to evaluate whether all the lesion reached the safe ablation boundary,and if there was any residual,it was timely treated with supplementary ablation.Enhanced MRI of the upper abdomen was performed 24 hours after the completion of the first treatment,1 month,3 months,6 months and 1 year after the first treatment,respectively.The standard for complete ablation was no enhancement in the lesions and their surrounding area of 0.5cm in the three stages of enhanced MR image.After found lesions residue,according to the actual situation to decide whether to salvage ablation.The rates of complete ablation were compared between the two groups.Short-term and medium-term efficacy were evaluated according to the rate of complete ablation by enhanced MR imaging analysis half a year and one year after the first treatment.AFP levels before surgery and one month after initial treatment were recorded in both groups.Results:The image fusion rate was 100%for the study group.58 lesions after the first treatment of complete ablation rate was 96.6%,the complete ablation rate was 94.8%after 1 month of therapy for the first time,complete ablation rate 93.1%,3 months,6 months complete ablation rate 89.7%,is apart from the first complete ablation rate of 84.5%a year after treatment,follow-up preoperative elevated AFP levels in 20 patients,patients with postoperative 1 month serum AFP level drop to normal 17 cases,2 cases fell slightly.58,microwave ablation lesions lesions after the first treatment of complete ablation rate was 96.6%,the complete ablation rate was 94.8%after 1 month of therapy for the first time,complete ablation rate 93.1%,3 months,6 months complete ablation rate 89.7%,is apart from the first complete ablation rate of 84.5%a year after treatment,follow-up of preoperative elevated AFP levels in 20 patients,patients with postoperative 1 month serum AFP level drop to normal 17 cases,2 cases fell slightly.In the control group,all 57 lesions were ablated under the guidance of ordinary ultrasound.24 hours after the first treatment,a complete ablation rate was 96.5%,a complete ablation rate of 96.5.%after 1 month,in 3 months,the complete ablation rate was 94.7%,a complete ablation rate of 93.0%in 6 months,and a complete ablation rate of 87.7%in 1 year after the first treatment.By statistical analysis,the complete efficiency of the two groups was compared 24 hours after the first treatment,1 month,3 months,6 months and 1 year after the treatment,and there was no significant statistical difference between the two groups.Follow-up preoperative elevated AFP levels in 20 patients,patients with postoperative 1 month serum AFP level drop to normal in 17 cases,2 cases fell slightly.Conclusion:US-MRI fusion volume navigation system in the microwave ablation of small liver cancer is the safe,feasible and effective method for treatment. |
PDF Full Text Request