Elek Alperen, Günkan Ahmet, Ohannesian Victor Arthur, Chadli Norhane, Oran Ismail
Department of Interventional Radiology, Faculty of Medicine, Ege University, Izmir, Turkey.
Division of Vascular and Interventional Radiology, Department of Radiology and Imaging Sciences, University of Arizona, Tucson, AZ, USA.
Cardiovasc Intervent Radiol. 2025 Aug 29. doi: 10.1007/s00270-025-04172-x.
This meta-analysis aims to evaluate thermal ablation for giant hepatic hemangiomas (GHHs) and compare the clinical outcomes of microwave ablation (MWA) and radiofrequency ablation (RFA).
A systematic review and meta-analysis followed the Cochrane Collaboration Handbook and PRISMA 2020 guidelines. Eligible studies reporting on patients with GHHs (≥ 4 cm) treated with MWA or RFA were identified through Medline, Scopus, and Web of Science databases. Primary outcomes included technical success (complete and accurate execution of the intended MWA or RFA procedure as per the study protocol), safety outcomes, clinical success, and radiological success. Statistical analyses were performed using a random-effects model, with heterogeneity assessed via the I statistic.
Fourteen studies (925 patients; 33.6% men; mean age: 46.6 years) with 1,010 GHHs were included. The overall technical success rate for thermal ablation was 99.95%, with a major complication rate of 2.21%. Clinical success, defined as symptom resolution or significant improvement, was achieved in 99.85% of patients, while radiological success, defined as at least a 50% reduction in lesion size, was observed in 89.81%. Minor complications were reported in 48.88%, and total complications in 52.43%, while procedure-related morbidity was low at 0.34%. In the subgroup analysis, radiological success was 95.6% in the MWA group and 86.3% in the RFA group (p = 0.073). Major complication rates were 1.99% for MWA and 2.08% for RFA (p = 0.93), while total complication rates were 46.0% and 58.1%, respectively (p = 0.43).
MWA and RFA are highly effective and safe options for treating GHHs, with excellent technical and clinical success rates. MWA may offer advantages in radiological success and lower complication rates.
本荟萃分析旨在评估热消融治疗巨大肝血管瘤（GHHs）的效果，并比较微波消融（MWA）和射频消融（RFA）的临床结果。
系统评价和荟萃分析遵循Cochrane协作手册和PRISMA 2020指南。通过Medline、Scopus和Web of Science数据库确定符合条件的关于接受MWA或RFA治疗的GHHs（≥4厘米）患者的研究。主要结局包括技术成功（按照研究方案完整准确地执行预期的MWA或RFA程序）、安全性结局、临床成功和影像学成功。采用随机效应模型进行统计分析，通过I统计量评估异质性。
纳入了14项研究（925例患者；男性占33.6%；平均年龄：46.6岁），共1010个GHHs。热消融的总体技术成功率为99.95%，主要并发症发生率为2.21%。99.85%的患者实现了临床成功，定义为症状缓解或显著改善，而89.81%的患者实现了影像学成功，定义为病变大小至少减少50%。48.88%的患者报告有轻微并发症，52.43%的患者有总并发症，而与手术相关的发病率较低，为0.34%。在亚组分析中，MWA组的影像学成功率为95.6%，RFA组为86.3%（p = 0.073）。MWA的主要并发症发生率为1.99%，RFA为2.08%（p = 0.93），而总并发症发生率分别为46.0%和58.1%（p = 0.43）。
MWA和RFA是治疗GHHs的高效且安全的选择，技术和临床成功率都很高。MWA在影像学成功和较低并发症发生率方面可能具有优势。
