Department of Interventional Ultrasound, Chinese PLA General Hospital , Beijing, China.
Int J Hyperthermia. 2011;27(5):517-22. doi: 10.3109/02656736.2011.563768. Epub 2011 May 24.
To investigate the feasibility, safety and efficacy of ultrasound guided percutaneous microwave (MW) ablation for small splenic metastasis.
A total of four patients with five pathologically proven splenic metastases (from ovarian, pulmonary, gastric adenocarcinoma and hepatocellular carcinoma, respectively) 1.3 to 2.9 cm in diameter were treated with microwave ablation. A cooled-shaft needle antenna was percutaneously inserted into the tumour under ultrasound guidance. One thermocouple was placed about 0.5 cm away from the tumour to monitor temperature in real time during ablation. Microwaves were emitted at 60 W for 600 s routinely and prolonged as necessary to attain temperatures sufficient to ensure tumour killing. Treatment efficacy was assessed by contrast-enhanced imaging at 1, 3 and 6 months, and every 6 months thereafter.
All tumours were completely ablated at a single session and no complications occurred. No local tumour progression was observed at a mean follow up of 22 ± 17.1 months (range 4 to 43 months). The ablation zone was well defined on contrast-enhanced imaging and it gradually shrank with time. One new metastatic lesion was detected in the spleen at 11 months after the ablation and was successfully treated by another MW ablation. The post-ablation survival was mean 22 months. No other complications were observed except for fever and abdominal pain.
Ultrasound-guided percutaneous MW ablation appears to be a safe and effective minimally invasive technique for management of small splenic metastasis in selected patients.
探讨超声引导经皮微波（MW）消融治疗小脾脏转移瘤的可行性、安全性和疗效。
共 4 例 5 个经病理证实的脾脏转移瘤患者（分别来自卵巢、肺、胃腺癌和肝细胞癌），瘤径 1.3-2.9cm，采用微波消融治疗。在超声引导下经皮插入冷轴针天线。在肿瘤旁约 0.5cm 处放置一个热电偶，以在消融过程中实时监测温度。常规发射 60W 微波 600s，必要时延长时间以达到足以确保肿瘤杀伤的温度。通过 1、3 和 6 个月及此后每 6 个月的增强成像评估治疗效果。
所有肿瘤均在单次治疗中完全消融，无并发症发生。在平均 22±17.1 个月（4-43 个月）的随访中，未观察到局部肿瘤进展。在增强成像上，消融区边界清晰，随时间逐渐缩小。在消融后 11 个月，脾脏中发现 1 个新的转移病灶，并通过另一次 MW 消融成功治疗。消融后生存时间平均为 22 个月。除发热和腹痛外，无其他并发症发生。
超声引导经皮 MW 消融术治疗小脾脏转移瘤在选择的患者中是一种安全有效的微创技术。
