ABSTRACT
Objective To study the feasibility,efficacy and safety of ultrasound-guided percutaneous radiofrequency ablation (RFA) in the treatment of hepatocellular carcinoma (HCC) in the caudate lobe.Methods From November 2006 to June 2017,31 patients with 31 HCCs located in the caudate lobe were treated with percutaneous RFA at the First Affiliated Hospital of Sun Yat-sen University.The treatment efficacy,complications,and the local tumor progression (LTP),disease-free survival (DFS) and overall survival (OS) rates were analyzed.Results Residual tumors were detected in 5 patients after the first treatment.Complete necrosis was achieved in all the patients after the second treatment.The mean number of ablation sessions was 1.16±0.37.At a follow-up period which ranged from 3 to 65 months,19 patients had died,10 patients were still alive,and 2 patients were lost to follow-up.The 1-,2-,3-,and 5-years OS rates were 78.4％,48.5％,12.1％ and 12.1％,respectively.On follow-up,9 caudate lobe HCC lesions were detected to have LTP.The 1-,2-,and 3-years LTP rates were 21.5％,41.6％ and 41.6％,respectively;while the 1-,2-,and 3-years DFS rates were 22.3％,11.2％ and 11.2％,respectively.Ablationrelated complications were detected in 4 patients.Conclusions Ultrasound-guided percutaneous RFA was safe and effective for patients with HCC in the caudate lobe.These patients should be followed-up closely to detect LTP.
ABSTRACT
ObjectiveTo evaluate the feasibility of a three-dimensional (3 D) operation planning system for precise hepatectomy in patients with giant hcpatocellular carcinoma (HCC).MethodsThe clinical data of 34 patients with giant HCC who received precise hepatectomy at the First Affiliated Hospital of Sun Yat-sen University from May 2009 to May 2011 were retrospectively analyzed.Preoperative evaluation was done based on the computed tomography data,and the resection margin and the volume of resectcd liver were calculated using simulation.The predicted resected liver volume and resection margins were compared with the results of the actual operations.All data were analyzed using the t test,and the correlation between predicted and the actual values was analyzed by calculating Pearson correlation coefficients.Results Hepatic and tumor tissues and the hepatic vessels were reconstructed three-dimensionally using the 3D preoperative simulation software.The volume of simulated resected liver and the length of resection margin were ( 2112 ± 1550 ) ml and ( 12 ± 6) mm,respectively,while the volume of actual resected liver and the length of resection margin were (2031 ± 1411 )ml and ( 12 ± 6)mm,respectively.The predicted and the actual values were statistically correlated ( r =0.961,0.923,P ＜ 0.05 ).There was no significant difference between the predicted and the actual values ( t =1.549,1.143,P ＞ 0.05 ).All patients received precise hepatectomy,and no hepatic failure or death was observed. Conclusion The 3D operation planning system can accurately evaluate the condition of the liver and simulate hepatectomy,and could contribute to safer and more curative precise hepatectomy in patients with giant HCC.
ABSTRACT
Objective To investigate the clinical value of iPass in three dimensional contrast enhanced MR angiography (3D-CE-MRA). Methods iPass were performed in 32 cases, including cervical vessel (4 cases), pulmonary vessel (7 cases), abdominal vessel (18 cases), and femoral vessel (3 cases). iPass bolus tracking was run before 3D-CE-MRA. The tracking sequence was operated repeatedly with real time display of image. The peak of bolus arrival time(Tp), identified with signal of target vessel increased 30% over baseline, was automatically loaded in the timing page of 3D-CE-MRA, and the time of scan delay(Td) was computed by the system with Tp. The acquired images were subtracted and reconstructed by MIP. The quality of MIP image was evaluated. Results The iPass bolus tracking sequence and 3D-CE-MRA were completed successfully in 29 cases. The bolus tracking couldn′t detect the bolus arrival time in 3 cases, but they were completed through changing ROI and bolus tracking repeatedly. The average score of 3D-CE-MRA MIP image was 3.81?0.59. Conclusion iPass can provide the exact Tp and automatically control Td of 3D-CE-MRA. iPass is a useful procedure to improve the image quality and provide the specific scanning scheme for 3D-CE-MRA.