经皮肝穿刺射频热凝治疗肝脏恶性肿瘤

Objective To study the therapeutic efficay of percutaneous radiofrequency ablation(PRFA)for hepatic malignancies and to definr its indications and its criteria of the curative effect.Methods In 100 patients with histologically of clinically confirmed hepatocellular carcinoma(HCC)or liver metastases we performed PRFA under ultrasound guidance using Le Veen multipolar array meedle electrode and RF 2000 generator.All patients were followed to identify complications and to assess treatment response.Results PRFA was performed in 76 patients with HCC and in 24 with liver metastases.The Alpha-fetoprotein(AFP)levles of the AFP positive HCC patients with inoperable small HCCs decreased to normal in 75.0%(21/28)and decreased markedly in 21.4%(6/28).Complete necrosis of small hepatic malignancies,documented by magnetic resonance imaging(MRI)was achieved in 85.9%(61/71).If the tumor shows iso-or hyper-intensity on Ti-weighted images,and relative hypointensity on T2-weighted images,and no enhanced intensity on dynamic contrast-enhanced MR imaging,it is considered completely coagulated.Conclusion PRFA is a novel local thermal palliative therapy for small hepatic malignancies that is minimally invasive,safe and effective.In patients with large lesions it can be combined with transarterial chemoembolization(TACE).Critera for curative treatment are normalization of serum AFP and /or MRI or CT scan findings showing complete necrosis.

Percutaneous radiofrequency ablation for hepatic malignancies

Objective To study the therapeutic efficay of percutaneous radiofrequency ablation (PRFA) for hepatic malignancies and to define its indications and its criteria of the curative effect. Methods In 100 patients with histologicallly or clinically confirmed hepatocellular carcinoma (HCC) or liver metastases we performed PRFA under ultrasound guidance using LeVeen multipolar array needle electrode and RF 2000 generator. All patients were followed to identify complications and to assess treatment response. Results PRFA was performed in 76 patients with HCC and in 24 with liver metastases. The Alpha-fetoprotein (AFP) levels of the AFP positive HCC patients with inoperable small HCCs decreased to normal in 75. 0% (21/28) and decreased markedly in 21.4% (6/28). Complete necrosis of small hepatic malignancies, documented by magnetic resonance imaging (MRI) was a-chieved in 85.9% (61/71). If the tumor shows iso- or hyper-intensity on Tl-weighted images, and relative hypointensity on T2-weighted images, and no enhanced intensity on dynamic contrast-enhanced MR imaging, it is considered completely coagulated. Conclusion PRFA is a novel local thermal palliative therapy for small hepatic malignancies that is minimally invasive, safe and effective. In patients with large lesions it can be combined with transarterial chemoembolization (TACE). Critera for curative treatment are normalization of serum AFP and/or MRI or CT scan findings showing complete necrosis.