Sotiria Athens General Hospital, Department of Medical Imaging and Interventional Radiology, Mesogeion Av 152, Athens, Greece.
Eur J Radiol. 2011 Feb;77(2):299-304. doi: 10.1016/j.ejrad.2009.07.003. Epub 2009 Sep 3.
To present a single center results, regarding radiofrequency ablation (RFA) of subcapsular hepatocellular carcinoma (HCC).
Forty patients with subcapsular HCC were treated with RFA under CT guidance for fifty-two discrete lesions in our institution. Twenty-eight patients underwent ablation of a solitary tumor and twelve patients underwent RFA of two tumors. Six patients had a subcapsular HCC with an exofitic location. All lesions had a diameter of <4 cm. We used two types of generators and electrodes: spiral electrode and expandable electrode. Needle track ablation was performed in all cases. Follow-up consisted of an abdomen computed tomography (CT) scan after contrast administration immediately after each session and then after one, three, six, and twelve months.
In forty-eight lesions complete tumor ablation was depicted at the one month CT scan. In four lesions with residual viable tumor, a second session was performed. After the second ablation no residual tumor was observed in any patient. No major complications occurred in any of our patients. Fever with a temperature up to 39 °C was documented during the first days as part of the post-ablation syndrome in thirteen patients (32.2%). Seeding along the needle track was observed in none of our patients. Local tumor progression, was observed in ten lesions (19.25%) and in all cases a second RFA session was performed with optimal results.
Subcapsular location should not be considered as a contraindication for liver RFA.
介绍单中心射频消融（RFA）治疗肝包膜下肝癌（HCC）的结果。
在我院，40 例肝包膜下 HCC 患者在 CT 引导下行 RFA 治疗，共 52 个离散病灶。28 例患者单个肿瘤行消融治疗，12 例患者行 2 个肿瘤消融治疗。6 例患者为肝包膜下 HCC 伴外生性部位肿瘤。所有病灶直径均<4cm。我们使用了两种类型的发生器和电极：螺旋电极和可膨胀电极。所有病例均行针道消融。随访包括每次治疗后立即行腹部 CT 扫描增强，然后分别在 1、3、6 和 12 个月时进行。
48 个病灶在 1 个月 CT 扫描时显示完全肿瘤消融。4 个有残留存活肿瘤的病灶行第二次消融。第二次消融后，所有患者均未见残留肿瘤。我们的患者均无重大并发症。13 例（32.2%）患者在术后前几天出现最高体温达 39°C 的发热，作为消融后综合征的一部分。我们的患者均未观察到针道种植。10 个病灶（19.25%）观察到局部肿瘤进展，所有病例均行第二次 RFA 治疗，效果良好。
肝包膜下位置不应被视为肝 RFA 的禁忌证。
