Department of Interventional Radiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
Department of Magnetic Resonance, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
Int J Hyperthermia. 2022 Dec;39(1):1044-1051. doi: 10.1080/02656736.2022.2107717.
To analyze the clinical safety and efficacy of 3.0-T closed MR-guided microwave ablation (MWA) for the treatment of HCC located under the hepatic dome.
From May 2018 to October 2020, 49 patients with 74 HCCs located under the hepatic dome underwent MWA using 3.0-T closed MR guidance. The technical success rate, operative time, complete ablation (CA) rate, complications, local tumor progression (LTP), tumor-free survival (TFS) and overall survival (OS) were examined. Routine blood analysis, liver/kidney function and alpha fetoprotein (AFP) and protein induced by vitamin k absent or antagonist (PIVKA) levels were compared before and 2 months after MWA.
All patients underwent MWA successfully, including 10 patients who underwent general anesthesia. The technical success rate was 100% without major complications. The CA rate was 95.9% (71/74) at the 2-month evaluation. The LTP rate was 2.7% during the median follow-up of 17.8 months (range: 4-43 months); the 6-, 12-, 18-month TFS rates were 97.8, 90.6, 68.1%, respectively, and the 6-, 12-, 18-month OS rates were 100, 97.6, 92.1%, respectively. There were no significant changes in routine blood tests and liver/kidney function ( > 0.05), while the AFP and PIVKA level decreased significantly at 2 months ( < 0.05).
3.0-T MR-guided MWA is safe and feasible for HCC lesions located under the hepatic dome.
分析 3.0T 闭孔磁共振引导下微波消融（MWA）治疗肝顶肝癌的临床安全性和疗效。
2018 年 5 月至 2020 年 10 月，49 例 74 个肝顶肝癌患者采用 3.0T 闭孔磁共振引导下 MWA 治疗。检查技术成功率、手术时间、完全消融（CA）率、并发症、局部肿瘤进展（LTP）、无瘤生存（TFS）和总生存（OS）。比较 MWA 前后常规血液分析、肝/肾功能、甲胎蛋白（AFP）和维生素 K 拮抗剂诱导蛋白（PIVKA）水平。
所有患者均成功接受 MWA 治疗，其中 10 例患者接受全身麻醉。无主要并发症，技术成功率 100%。2 个月评估时 CA 率为 95.9%（71/74）。中位随访 17.8 个月（范围：4-43 个月）时 LTP 率为 2.7%；6、12、18 个月 TFS 率分别为 97.8%、90.6%、68.1%，6、12、18 个月 OS 率分别为 100%、97.6%、92.1%。常规血液检查和肝肾功能无明显变化（>0.05），而 AFP 和 PIVKA 水平在 2 个月时明显下降（<0.05）。
3.0T 磁共振引导下 MWA 治疗肝顶肝癌安全可行。
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