Asvadi Nazanin H, Anvari Arash, Uppot Raul N, Thabet Ashraf, Zhu Andrew X, Arellano Ronald S
Department of Radiology, Division of Interventional Radiology, Massachusetts General Hospital, White 270, Boston, MA 02114.
Department of Radiology, Division of Interventional Radiology, Massachusetts General Hospital, White 270, Boston, MA 02114.
J Vasc Interv Radiol. 2016 Apr;27(4):496-502; quiz 503. doi: 10.1016/j.jvir.2016.01.010. Epub 2016 Feb 28.
To evaluate the technique, efficacy, safety, and clinical outcomes of CT-guided microwave ablation of tumors in the hepatic dome.
Retrospective review was conducted of 46 consecutive patients (31 men and 15 women; mean age, 64 y) treated with CT-guided microwave ablation for hepatic-dome tumors between June 2011 and December 2014. Baseline demographics of sex, tumor diagnosis, tumor location, tumor size, and technical details were recorded. Technical success was evaluated. Treatment response was assessed per European Association for the Study of the Liver criteria. Overall success and overall survival were calculated, and complications were recorded.
Forty-eight tumors were treated. Tumor locations included segments VIII (n = 32), VII (n = 10), and VIa (n = 6). Mean tumor size was 2.4 cm (range, 0.9-5.2 cm). Thirty-four tumors (70%) were treated following creation of artificial ascites with 0.9% normal saline solution (mean volume, 1,237 mL; range, 300-3,000 mL). The technical success rate was 100%, and the complete response rate was 94%. Overall survival rate was 73.9% over 24.7 months of follow-up. There were no major complications. Two patients experienced small, asymptomatic pneumothoraces that were aspirated at the time of the procedure and required no further treatment.
CT-guided microwave ablation of tumors in the hepatic dome is associated with a high technical success rate, high complete response rate, and low complication rate.
评估CT引导下肝顶部肿瘤微波消融的技术、疗效、安全性及临床结果。
回顾性分析2011年6月至2014年12月期间连续46例接受CT引导下肝顶部肿瘤微波消融治疗的患者（31例男性，15例女性；平均年龄64岁）。记录患者的性别、肿瘤诊断、肿瘤位置、肿瘤大小等基线人口统计学数据及技术细节。评估技术成功率。根据欧洲肝脏研究协会标准评估治疗反应。计算总体成功率和总生存率，并记录并发症。
共治疗48个肿瘤。肿瘤位置包括Ⅷ段（n = 32）、Ⅶ段（n = 10）和Ⅵa段（n = 6）。平均肿瘤大小为2.4 cm（范围0.9 - 5.2 cm）。34个肿瘤（70%）在注入0.9%生理盐水人工腹水（平均量1237 mL；范围300 - 3000 mL）后进行治疗。技术成功率为100%，完全缓解率为94%。随访24.7个月的总生存率为73.9%。无严重并发症。2例患者出现小的无症状气胸，术中进行了抽吸，无需进一步治疗。
CT引导下肝顶部肿瘤微波消融技术成功率高、完全缓解率高、并发症发生率低。
