Ghanaati Hossein, Abrishami Alireza, Hashem Zadeh Arezou, Ghiasi Mahdi, Nasiri Toosi Mohssen, Jafarian Ali
Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center, Medical Imaging Center, Imam Khomeini Hospital, Tehran University of Medical Science, Tehran, Iran.
Department of Radiology, Shahid Labbafinejad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
J Vasc Interv Radiol. 2022 Nov;33(11):1342-1348.e1. doi: 10.1016/j.jvir.2022.07.015. Epub 2022 Jul 19.
To determine the safety and efficacy of computed tomography (CT) fluoroscopy-guided percutaneous transhepatic sclerotherapy with a bleomycin/ethiodized oil emulsion for symptomatic giant hepatic hemangiomas.
The procedure was performed on 22 patients with symptomatic giant hepatic hemangiomas in an outpatient setting between 2018 and 2020. All patients were followed clinically and underwent contrast-enhanced magnetic resonance imaging after 1 month and again at a mean time of 15 months ± 2. Adverse events were classified according to the Common Terminology Criteria for Adverse Events (CTCAE, v5.0), in which a severe adverse event was defined as an adverse event with a grade of ≥3. The desired radiologic response (volume and index size) and improvement of pain intensity (visual analog scale [VAS]) and other symptoms were recorded as outcomes.
Overall, patients showed a 36.4% ± 8.6 reduction in volume and a 14% ± 1.6 reduction in index size after 1 month, with P values of .002 and .001, respectively. The final follow-up volume and index size were 194.7 cm ± 25.8 and 77 mm ± 36, respectively. Moreover, a 53.0% ± 7 reduction in volume and 22% ± 3.7 reduction in index size during the final imaging were reported, with the P values of .001 and .001, respectively. Significant reductions in the mean pain intensity (90% of patients with lower VAS scores after intervention) and symptoms were reported. Four patients were classified as clinically unsuccessful, and were recommended further procedures for residual pain.
CT fluoroscopy-guided transhepatic sclerotherapy is an effective, safe, and minimally invasive method to manage giant hepatic hemangiomas in an outpatient setting.
确定计算机断层扫描（CT）透视引导下经皮经肝注射博来霉素/乙碘油乳剂硬化治疗有症状的巨大肝血管瘤的安全性和有效性。
2018年至2020年期间，在门诊对22例有症状的巨大肝血管瘤患者进行了该治疗。所有患者均接受临床随访，并在1个月后及平均15个月±2个月时再次接受对比增强磁共振成像检查。不良事件根据《不良事件通用术语标准》（CTCAE，第5.0版）进行分类，其中严重不良事件定义为≥3级的不良事件。记录预期的放射学反应（体积和指数大小）以及疼痛强度（视觉模拟量表[VAS]）和其他症状的改善情况作为结果。
总体而言，患者在1个月后体积减少了36.4%±8.6%，指数大小减少了14%±1.6%，P值分别为0.002和0.001。最终随访时的体积和指数大小分别为194.7 cm±25.8和77 mm±36。此外，在最终成像时报告体积减少了53.0%±7%，指数大小减少了22%±3.7%，P值分别为0.001和0.001。报告显示平均疼痛强度（干预后90%的患者VAS评分降低）和症状有显著减轻。4例患者被判定临床治疗失败，并被建议针对残留疼痛进行进一步治疗。
CT透视引导下经肝硬化治疗是在门诊治疗巨大肝血管瘤的一种有效、安全且微创的方法。
