Liang H L, Yang C F, Pan H B, Lai K H, Cheng J S, Lo G H, Chen C K, Lai P H
Department of Radiology, Kaohsiung Veterans General Hospital, Taiwan.
Radiology. 2000 Mar;214(3):769-74. doi: 10.1148/radiology.214.3.r00mr06769.
To evaluate the safety and efficacy of single high-dose percutaneous acetic acid injection (PAI) for treatment of small (<3-cm-diameter) hepatocellular carcinoma (HCC).
Eighteen patients with HCC (22 nodules; diameter range, 1.5-3.0 cm) underwent single PAI. With ultrasonographic or computed tomographic (CT) guidance, 4-11 mL of 50% acetic acid was slowly injected into the center of the nodule through a skinny multiple-side-hole needle. Follow-up was performed with helical contrast material-enhanced CT. Complications of high-dose PAI were recorded.
Seventeen nodules showed no local recurrence (follow-up, 6-29 months) after single PAI. At a mean follow-up of 15.6 months, mean tumor diameter was 2.1 cm and mean injected volume was 6.4 mL. Four nodules showed residual tumor (mean tumor diameter, 2.6 cm; mean injected volume, 5.8 mL). The mean ratio of injected to estimated volume of acetic acid was 1.21 in cases of successful single PAI and 0.72 in cases of local recurrence (P < .001). One patient with preexistent right portal venous thrombosis died of hepatic failure 37 days after PAI. Other complications included severe pain (11%), high fever (4%), and segmental wedge infarction (4%).
Single high-dose PAI is safe and effective for treatment of small HCC.
评估单次大剂量经皮乙酸注射（PAI）治疗小（直径<3 cm）肝细胞癌（HCC）的安全性和有效性。
18例HCC患者（22个结节；直径范围1.5 - 3.0 cm）接受单次PAI治疗。在超声或计算机断层扫描（CT）引导下，通过细的多侧孔针将4 - 11 mL 50%的乙酸缓慢注入结节中心。采用螺旋增强CT进行随访。记录大剂量PAI的并发症。
17个结节在单次PAI后无局部复发（随访6 - 29个月）。平均随访15.6个月时，平均肿瘤直径为2.1 cm，平均注射量为6.4 mL。4个结节有残留肿瘤（平均肿瘤直径2.6 cm；平均注射量5.8 mL）。单次PAI成功病例中乙酸注射量与估计体积的平均比值为1.21，局部复发病例中为0.72（P < .001）。1例术前存在右门静脉血栓形成的患者在PAI后37天死于肝衰竭。其他并发症包括剧痛（11%）、高热（4%）和节段性楔形梗死（4%）。
单次大剂量PAI治疗小HCC安全有效。
