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超声引导下经皮射频消融治疗肝海绵状血管瘤

Ultrasonography guided percutaneous radiofrequency ablation for hepatic cavernous hemangioma.

作者信息

Cui Yan, Zhou Li-Yan, Dong Man-Ku, Wang Ping, Ji Min, Li Xiao-Ou, Chen Chang-Wei, Liu Zi-Pei, Xu Yong-Jie, Zhang Hong-Wen

机构信息

Department of Hepatobiliary Surgery, Beijing 306 Hospital, Chaoyang District, Beijing 100101, China.

出版信息

World J Gastroenterol. 2003 Sep;9(9):2132-4. doi: 10.3748/wjg.v9.i9.2132.

Abstract

AIM

Hepatic cavernous hemangioma (HCH) is the most common benign tumor of the liver and its management is still controversial. Recent success in situ radiofrequency ablation of hepatic malignancies has led us to consider using this technique in patients with HCH. This study was to assess the efficacy, safety, and complications of percutaneous radiofrequency ablation (PRFA) under ultrasonography guidance in patients with HCH.

METHODS

Twelve patients (four men and eight women, age ranged 33-56 years, mean age was 41.7 years) with 15 hepatic cavernous hemangiomas (2.5 cm to 9.5 cm) were treated using the RF-2000 generator and 10-needle LeVeen electrode percutaneously guided by B-ultrasound. Lesions larger than 3 cm were treated by multiple overlapping ablations that encompass the entire lesion as well as a rim of normal liver tissue (approximately 0.5 cm).

RESULTS

All the patients who received PRFA therapy had no severe pain, bleeding or bile leakage during and after the procedures. Nine to 34 months' follow-up (mean, 21 months) by ultrasound and/or spiral CT scan demonstrated that the ablated lesions in this group were shrunk remarkably, and the shrunken range was 38-79 % (mean, 67 % per 21 months). The contrast enhancement was disappeared within the tumor or at its periphery in all cases on spiral CT scans obtained 3 to 6 months after treatment.

CONCLUSION

The results of this study suggest that PRFA therapy is a mini-invasive, simple, safe, and effective method for the treatment of selected patients with HCH.

摘要

目的

肝海绵状血管瘤(HCH)是肝脏最常见的良性肿瘤,其治疗方法仍存在争议。近期肝脏恶性肿瘤原位射频消融取得的成功促使我们考虑将该技术应用于HCH患者。本研究旨在评估超声引导下经皮射频消融(PRFA)治疗HCH患者的疗效、安全性及并发症。

方法

12例患者(4例男性,8例女性,年龄33 - 56岁,平均年龄41.7岁),共15个肝海绵状血管瘤(直径2.5 cm至9.5 cm),采用RF - 2000发生器及10针LeVeen电极,在B超引导下经皮进行治疗。直径大于3 cm的病灶采用多次重叠消融,覆盖整个病灶及周边约0.5 cm的正常肝组织。

结果

所有接受PRFA治疗的患者在术中及术后均无严重疼痛、出血或胆漏。超声和/或螺旋CT扫描随访9至34个月(平均21个月)显示,该组消融病灶明显缩小,缩小范围为38% - 79%(平均每21个月缩小67%)。治疗后3至6个月的螺旋CT扫描显示,所有病例肿瘤内部或周边的对比增强均消失。

结论

本研究结果表明,PRFA治疗是一种微创、简单、安全且有效的方法,可用于治疗部分HCH患者。

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