Song Kyoung Doo, Rhim Hyunchul, Lee Min Woo, Kang Tae Wook, Lim Sanghyeok
1 Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul , South Korea.
2 Department of Radiology, Guri Hospital, Hanyang University College of Medicine , Guri , South Korea.
Br J Radiol. 2018 May;91(1085):20170585. doi: 10.1259/bjr.20170585. Epub 2018 Mar 8.
The need for liver biopsy has been increasing because genetic testing of specimens has become important for determining prognosis and management in patients with hepatic malignancy. We evaluated the feasibility of a device for biopsy tract ablation in patients with hepatic masses.
This prospective single-center pilot study was approved by our institutional review board and patients provided written informed consent. Between September 2015 and March 2016, 10 patients (6 males and 4 females, 35-66-years-old) who had hepatic masses and normal range of platelet count and prothrombin time were enrolled. After percutaneous ultrasound-guided biopsy, the biopsy tract was ablated with the device which consists of an insulation sheath and a radiofrequency applicator. Complications were evaluated with Doppler ultrasound immediately after the biopsy, with noncontrast abdominopelvic CT the day after the biopsy, and with a telephone interview 7 days after the biopsy.
Tract ablation did not cause any pain in seven patients and caused minimal pain in three3 patients. Tract ablation was performed for a mean of 4.8 s (range, 4-6 s). No adverse events occurred during the procedure. Bleeding through the biopsy tract was not apparent on Doppler ultrasound, and abnormal fluid was not detected in the abdominal cavity on CT. Procedure-related complications were not reported on telephone interview.
Biopsy tract ablation with the device is technically feasible. If the device is used appropriately considering its potential advantages, it may help to reduce the risk of complications associated with liver biopsy. Advances in knowledge: It is technically feasible to perform biopsy tract ablation with the radiofrequency ablation device after liver biopsy.
由于对标本进行基因检测对于确定肝恶性肿瘤患者的预后和治疗至关重要，肝活检的需求一直在增加。我们评估了一种用于肝肿块患者活检通道消融的设备的可行性。
这项前瞻性单中心试点研究已获得我们机构审查委员会的批准，患者提供了书面知情同意书。在2015年9月至2016年3月期间，纳入了10例肝肿块患者（6例男性和4例女性，年龄35 - 66岁），其血小板计数和凝血酶原时间在正常范围内。在经皮超声引导下活检后，使用由绝缘鞘和射频施加器组成的设备对活检通道进行消融。在活检后立即用多普勒超声评估并发症，活检后第二天用非增强腹部盆腔CT评估，活检后7天通过电话访谈评估。
通道消融在7例患者中未引起任何疼痛，在3例患者中引起轻微疼痛。通道消融平均进行4.8秒（范围4 - 6秒）。手术过程中未发生不良事件。多普勒超声显示活检通道无明显出血，CT检查未在腹腔内检测到异常液体。电话访谈未报告与手术相关的并发症。
使用该设备进行活检通道消融在技术上是可行的。如果考虑到其潜在优势适当地使用该设备，可能有助于降低与肝活检相关的并发症风险。知识进展：肝活检后使用射频消融设备进行活检通道消融在技术上是可行的。
