CEUS引导射频消融联合瘤体内血液抽吸治疗肝血管瘤的安全性及临床效果

目的探讨CEUS引导射频消融(RFA)联合瘤体内血液抽吸治疗肝血管瘤(HCH)的安全性及临床效果。方法回顾性分析2010年1月—2016年12月接受CEUS引导RFA联合瘤体内血液抽吸治疗的55例HCH患者(共77个病灶)的资料。治疗前均经常规超声及CEUS明确瘤体大小及血供情况,治疗后即刻及治疗后3个月复查常规超声及CEUS,计算术后即刻及术后3个月瘤体容积、瘤体缩小率及治疗后3个月瘤体血供完全消失率,并进行统计学分析。结果平均治疗时间(31.53±15.89)min,平均瘤体内血液抽吸量(135.36±68.13)ml。术中瘤体内血液抽吸量与治疗前瘤体容积呈正相关(r=0.722,P0.05)。55例HCH患者治疗后均未出现相关严重并发症,9例(9/55,16.36%)发生轻微并发症。治疗后即刻及治疗后3个月瘤体容积均较治疗前明显减小(P均0.05),平均瘤体缩小率分别为(48.76±32.58)%及(22.37±35.73)%。治疗后3个月瘤体血供完全消失率为96.10%(74/77)。结论 CEUS引导RFA联合瘤体内血液抽吸治疗HCH是一种安全、有效的方法,有可能成为治疗HCH的首选手段。

Safety and efficacy of CEUS-guided percutaneous radiofrequency ablation combined with extracting blood from hemangiomas in treatment of hepatic cavernous hemangiomas

Objective To investigate the safety and efficacy of radiofrequency ablation (RFA) combined with extracting blood from hemangiomas guided with CEUS for treating hepatic cavernous hemangiomas (HCH). Methods Data of 55 patients with 77 lesions of HCH underwent CEUS guided RFA combined with extracting blood from hemangiomas during January 2010 to December 2016 were retrospectively analyzed. Conventional ultrasound and CEUS were performed before therapy,in order to obtain the size and blood supply information of lesions, also performed immediately after treatment and 3 months later to calculate the volume of hemangiomas and the rate of hemangiomas after the treatment, as well as the rate of non-blood supply 3 months after the treatment. Then statistical analysis was done. Results The mean operation time was (31.53±15.89)min, and the blood extracting from hemangiomas was (135.36±68.13)ml. There was positive correlation between the volume of hemangiomas before treatment and the blood extracting from hemangiomas (r=0.722, P<0.05). No serious complication occurred among 55 cases, while mild complications happened in 9 cases (9/55, 16.36%). The volume of hemangiomas decreased immediately and 3 months after treatment (both P<0.05), and the rate of hemangiomas reducing was (48.76±32.58)% and (22.37±35.73)%, respectively. The rate of non-blood supply 3 months after treatment was 96.10% (74/77). Conclusion CEUS-guided RFA combined with extracting blood from hemangiomas is an effective and safe method, which has potential to become a first-line therapy.