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经皮微波消融治疗肝脏良性局灶性病变:初步临床结果

Percutaneous microwave ablation for benign focal liver lesions: Initial clinical results.

作者信息

Cheng Zhigang, Liang Ping, Yu Xiaoling, Han Zhiyu, Liu Fangyi, Yu Jie, Li Xin

机构信息

Department of Interventional Ultrasound, Chinese People's Liberation Army General Hospital, Beijing 100853, P.R. China.

出版信息

Oncol Lett. 2017 Jan;13(1):429-434. doi: 10.3892/ol.2016.5409. Epub 2016 Nov 22.

Abstract

Benign focal liver lesions (BFLLs) have become a common disease diagnosed in the clinical setting following the advancement of imaging techniques. The aim of the present study was to evaluate the safety and clinical outcomes of percutaneous microwave (MW) ablation, guided by ultrasound (US), for the treatment of BFLLs. Between May 2005 and January 2011, 44 BFLLs (mean maximum diameter, 33.9±13.1 mm) in 37 patients (23 women and 14 men) were treated by US-guided percutaneous MW ablation with cooled-shaft antennae. The pathological diagnosis of a BFLL was confirmed in 91.9% (34/37) of patients using a US-guided core needle biopsy prior to ablation. The BFLLs in the other 3 cases were diagnosed by typical presentations on contrast-enhanced imaging, as the patients refused to undergo biopsies. Five inclusion criteria, including indeterminate diagnoses of nodules on contrast-enhanced imaging prior to pathological verification, were recommended. The median follow-up period was 27.0 months (range, 6-73 months). The mean MW ablation energy and time were 55.0±41.6 kJ (range, 13.5-207 kJ) and 1,039.9±706.2 sec (range, 270-3,450 sec) per lesion, respectively. In total, 40 nodules (90.9%) were completely ablated, and no evidence of recurrence was demonstrated on contrast-enhanced imaging follow-up. The other 4 nodules (9.1%) were partially ablated due to the proximity of adjacent vital organs. Minor complications without sequelae included local pain and transient hemoglobinuria and no major complications occurred in peri-ablation. Overall, US-guided percutaneous MW ablation is a safe, effective and minimally invasive therapy for BFLLs in selected patients who are non-surgical candidates.

摘要

随着成像技术的进步,良性局灶性肝病变(BFLLs)已成为临床诊断中的常见疾病。本研究的目的是评估在超声(US)引导下经皮微波(MW)消融治疗BFLLs的安全性和临床疗效。2005年5月至2011年1月期间,对37例患者(23例女性和14例男性)的44个BFLLs(平均最大直径33.9±13.1mm)进行了超声引导下带冷却轴天线的经皮MW消融治疗。在消融前,91.9%(34/37)的患者通过超声引导下的粗针活检确诊为BFLLs。另外3例患者因拒绝活检,通过对比增强成像的典型表现诊断为BFLLs。推荐了五项纳入标准,包括在病理验证前对比增强成像上结节诊断不明确。中位随访期为27.0个月(范围6 - 73个月)。每个病灶的平均MW消融能量和时间分别为55.0±41.6kJ(范围13.5 - 207kJ)和1039.9±706.2秒(范围270 - 3450秒)。总共40个结节(90.9%)完全消融,对比增强成像随访未显示复发迹象。另外4个结节(9.1%)因邻近重要器官而部分消融。轻微并发症无后遗症,包括局部疼痛和短暂性血红蛋白尿,消融期间未发生重大并发症。总体而言,对于非手术候选的特定患者,超声引导下经皮MW消融是治疗BFLLs的一种安全、有效且微创的疗法。

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