Abstract
BackgroundTo evaluate the value of a three dimension (3D)visualization operative planning system in ultrasound-guided percutaneous microwave ablation (US-PMWA) for large hepatic hemangiomas (LHHs).MethodsFifty-eight patients with LHHs were divided into 3D and 2D groups. The therapeutic efficacy was assessed by contrast-enhanced imaging during follow-up. Hepatic and renal function were examined. The complete ablation, tumor volume shrinkage, and complication rates were analyzed.ResultsThe ablation time and energy of the 3D group were lower than those of the 2D group (1152.0 ± 403.9 s vs. 1379.7 ± 375.8 s and 87,407.2.9 ± 50,387.0 J vs. 117,775.8 ± 46,245.6 J, P = 0.031 and 0.021, respectively). The 3D group had a higher complete ablation rate than the 2D group (97.7 ± 2.4% vs. 94.5 ± 3.7%, P < 0.001). The incidence of hemoglobinuria after ablation in the 3D group was lower than that in the 2D group (32.0% vs. 57.6%, P = 0.047). The levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and creatinine (Cre) after ablation in the 3D group were lower than those in the 2D group (126.7 ± 56.4 U/L vs. 210.9 ± 96.2 U/L, P < 0.001; 141.0 ± 60.8 U/L vs. 211.4 ± 90.0 U/L, P = 0.001; 57.3 ± 17.6 U/L vs. 80.8 ± 41.9 U/L, P = 0.010; and 66.6 ± 16.6 mmol/L vs. 84.5 ± 39.6 mmol/L, P = 0.037, respectively). There were no significant differences in antenna insertion and the volume reduction rate between the groups. One patient developed acute kidney injury shortly after ablation in the 2D group and recovered after hemodialysis. No other severe complications occurred during the follow-up period.ConclusionsThe 3D visualization operative planning system has a relatively high clinical application value in providing scientific, reasonable, quantifiable, and individualized therapy for LHHs by US-PMWA.
Highlights
To evaluate the value of a three dimension (3D)visualization operative planning system in ultrasoundguided percutaneous microwave ablation (US-PMWA) for large hepatic hemangiomas (LHHs)
The purpose of this study was to explore the clinical value of a 39]. A three dimensional (3D) visualization operative planning system in ultrasoundguided percutaneous microwave ablation (US-PMWA) for large hepatic hemangiomas compared to the 2D operative planning system
The inclusion criteria for US-PMWA were as follows: (1) definite diagnosis of LHH ≥5 cm based on the typical enhancement pattern on contrast-enhanced computed tomography (CT), magnetic resonance imaging (MRI), or contrast-enhanced ultrasound (CEUS); (2) clinical symptoms typically caused by LHHs present for at least 1 year, including abdominal pain, nausea, vomiting, abdominal fullness, and serious mental burden [10, 11]; (3) diagnoses of LHH pathologically proven by ultrasound (US)-guided core needle biopsy before ablation; and (4) prothrombin time < 25 s; prothrombin activity > 40%; and platelet count > 60 cells × 109/L
Summary
To evaluate the value of a three dimension (3D)visualization operative planning system in ultrasoundguided percutaneous microwave ablation (US-PMWA) for large hepatic hemangiomas (LHHs). Other therapies, including liver transplantation, transcatheter arterial embolization [19,20,21,22], radiation therapy [23, 24], thermal ablation (radiofrequency and microwave ablation) [3, 8, 11, 25,26,27], and medications (bevacizumab, sorafenib, cisplatin and bleomycin) [28, 29], have been reported in the management of LHHs. In some cases, operative treatment of LHHs remains a challenge for surgeons because of massive intraoperative blood loss and difficulty in controlling bleeding [30, 31]. Microwave ablation is a better choice for the treatment of symptomatic LHHs
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