Jung Seung Eun, Cho Se Hyun, Jang Jin Hee, Han Joon-Yeol
Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Abdom Imaging. 2011 Apr;36(2):185-95. doi: 10.1007/s00261-010-9628-2.
To evaluate the complications of high-intensity focused ultrasound (HIFU) in patients with hepatic and pancreatic cancer.
From January 2006 to December 2008, 133 sessions of HIFU treatment were performed in 114 consecutive patients with primary hepatic tumor (n = 57), hepatic metastasis (n = 22), and pancreatic cancer (n = 35) under general anesthesia. The extracorporeal, ultrasound-guided Model-JC system (HAIFU, Chongqing, China) was used. Artificial pleural effusion was created to obtain an adequate sonographic window for ablating hepatic dome masses in 53 patients. We reviewed medical records and imaging findings before, during, and after HIFU.
All patients had skin redness, edema, and pain in the treatment regions. All hepatic tumor patients had necrosis of the ribs along the main ultrasound beam path that did not require further treatment. Major complications included biliary obstruction, symptomatic pleural effusion, pneumothorax and fistula formation between an abdominal wall abscess and the ablated hepatic tumor. In 35 pancreatic cancer patients, major complications included third-degree burns and fistula formation between the tumor and duodenum. Delayed complications in hepatic tumor patients included a diaphragmatic rupture and rib fractures along the ultrasound pathway.
The complications of HIFU develop mainly around the targeted lesions or along the ultrasound beam pathway. It is essential to have awareness of the possible complications related to HIFU and its imaging features for to avoiding serious complications.
评估高强度聚焦超声（HIFU）治疗肝癌和胰腺癌患者的并发症。
2006年1月至2008年12月，对114例连续性原发性肝癌（n = 57）、肝转移癌（n = 22）和胰腺癌（n = 35）患者在全身麻醉下进行了133次HIFU治疗。使用体外超声引导的JC型系统（海扶，中国重庆）。53例患者通过制造人工胸腔积液以获得足够的超声窗来消融肝顶部肿块。我们回顾了HIFU治疗前、治疗期间及治疗后的病历和影像学检查结果。
所有患者治疗区域均出现皮肤发红、水肿和疼痛。所有肝癌患者沿主要超声束路径的肋骨均发生坏死，无需进一步治疗。主要并发症包括胆管梗阻、有症状的胸腔积液、气胸以及腹壁脓肿与消融后的肝肿瘤之间形成瘘管。在35例胰腺癌患者中，主要并发症包括三度烧伤以及肿瘤与十二指肠之间形成瘘管。肝癌患者的延迟并发症包括膈肌破裂和沿超声路径的肋骨骨折。
HIFU的并发症主要发生在靶病变周围或沿超声束路径。了解与HIFU相关的可能并发症及其影像学特征对于避免严重并发症至关重要。
