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Objective To explore the clinical significance of dynamic 3-dimensional contrast-enhanced ultrasound (D-3D-CEUS) in assessing the efficacy of microwave ablation (MWA) therapy of hepatocellular carcinoma (HCC). Methods Two hundred and fifty-one HCC lesions from 185 patients undergoing ultrasound-guided percutaneous MWA were studied by D-3D-CEUS and contrast-enhanced computed tomography(CECT) one month after ablation.Imaging results from two imaging modalities were evaluated independently to determine whether the treated lesions were ablated incompletely (residual lesion) or completely.The final diagnosis standard was biopsy pathology or clinical follow-up results.Results One hundred and eighty-five patients were successfully ablated completely.There was no serious complication observed.The final diagnosis standard identified 93.2% (234/251) of ablated lesions as complete ablation and 6.8% (17/251) as incomplete. With the final diagnosis as the reference standard,the sensitivity, specificity,positive predictive value,negative predictive value,and accuracy of D-3D-CEUS and CECT were 82.4% (14/17) vs 88.2% (15/17),98.3% (230/234) vs 97.4% (228/234),77.8% (14/18) vs 71.4%(15/21),98.7% (230/233) vs 99.1% (228/230),97.2% (244/251) vs 96.8% (243/251),respectively. The difference between the D-3D-CEUS and CECT was not statistically significant(χ2=0.14,P =1.00).The consistency analysis showed that D-3D-CEUS and CECT were highly consistent with the final diagnosis standard (Kappa=0.81,P =0.00).Conclusions D-3D-CEUS imaging can be used for assessment of HCC MWA and be used as a useful supplement for CECT.
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Objective To investigate the feasibility and clinical effect for percutaneous microwave ablation of type I substernal goiter under the guidance of ultrasound . Methods Thirteen patients with type I substernal goiter were selected . All patients underwent percutaneous microwave ablation treatment under the guidance of ultrasound . Thirteen patients with 47 medals nodules were performed ultrasound guided percutaneous microwave ablation . Intraoperative heat blocking blood flow was used to prevent severe hemorrhage .Liquid isolation belt and leverage from methods were used to effectively prevent surrounding important structures against heat damage .Small amount of residual method was used to avoid tracheal collapse . All patients were followed up post‐operative 1 ,3 ,6 ,12 months by monitoring of thyroid nodule volume change , adverse reactions , and postoperative complications . Results Thirteen patients with 47 medals nodules were successfully performed percutaneous microwave ablation guided by ultrasound . Among them ,2 patients performed the second treatment for too large volume of goiter ,tracheal displacement and poor physical tolerance of older . The postoperative ultrasound contrast and color Doppler showed that the lesions were completely inactivated . No obvious complications occurred in all 13 patients , and no permanent hoarseness occured . The symptoms of cervical oppression and discomfort disappeared for all patients within 1-4 months after surgery . Thirteen patients were followed up for 12 months after the operation . The thyroid function was normal and the volume reduction rate of thyroid nodules was (85 ± 31)% . Conclusions Percutaneous microwave ablation of type I substernal goiter under ultrasonic guidance is a safe and effective method to reduce the thyroid nodules with no serious complications . It is worth to be popularized in clinical practice .
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Objective To evaluate the feasibility and efficacy of ultrasound-guided percutaneous microwave ablation combined with hormone suppression therapy for solitary papillary thyroid microcarcinoma.Methods A total of 25 patients with 25 nodules pathologically proven solitary papillary carcinoma 3.7 to 10.0 mm in diameter without clinically apparent lymph node,or distant metastasis were treated with microwave ablation equipement.Microwaves were emitted at 40 W for 200 -400 seconds and prolonged as necessary to attain confluent ablation zones.All patients were treated with both extended ablation therapy and levothyroxine that maintain TSH levels below 0.1 mU/L.Thyroid function test,nodule volume and clinical symptom were evaluated before ablation and during 1 ,3,6,9 and 12 months after treatment according to changes in tumor size,adverse reactions,complications and metastatic tumors.Three out of 25 patients received surgical treatment and the other 22 patients were followed up with routine ultrasound and contrast enhanced ultrasound.Results All 25 tumors were completely ablated by using mutiple plane fixed melting method and no serious or permanent complications occurred.No recurrence at the treatment site or distant metastase were detected,with a mean follow-up of 1 8 months.Histological examination showed no evidence of a tumor in the treated lesions in the 3 surgery patients.Conclusions Ultrasound-guided percutaneous microwave ablation appears to be a safe and effective technique for the therapy of solitary papillary thyroid microcarcinoma.
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Objective To investigate the effectiveness and safety of ultrasound-guided percutaneous microwave ablation in the treatment of benign thyroid nodules.Methods A total 456 patients (912 nodules) underwent microwave ablation in our department.Microwave ablation was carried out using microwave antenna under local anesthesia.Nodule volume,thyroid function and clinical symptoms were evaluated before treatment and at 1 ,3,6 and 12 months after the treatment to monitor changes in the volume,adverse effect and complications.Results 912 nodules were all studied with contrast-enhanced ultrasound immediately after the ablation,and all results showed “black hole”sign.The mean follow-up period after microwave ablation was (9±6)months (range,3-24 months).At 6-month follow-up,the mean volume reduction ratio of the solid nodules,mixed nodules and the cystic nodules was (61 ± 50 )%,(81 ± 33 )%,(89 ± 46 )%, respectively.The treatment was well tolerated and no major complications were observed except pain and transient voice changes (2.4%).Conclusions Microwave ablation is a safe and effective technique for the treatment of benign thyroid nodules.
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Objective To investigate the efficiency of radiofrequency ablation (RFA) and microwave ablation (MWA) in treating uterine leiomyoma.Methods The clinical data of thermal ablation with RFA and MWA were retrospectively analyzed in 42 patients.All patients were followed up at least 12 months to observe the therapeutic effects after the treatment.The changes of vital signs and the size of uterine leiomyoma,the score of uterine leiomyoma symptom and quality of Iife(UFS-QOL) were compared after RFA or MWA,the two thermal ablations techniques of clinic efficiency and influence on complications were analyzed.Results 23 patients received treatment of RFA and 19 patients received MWA,the visual analogue scale(VAS)during operation and postoperation were statistically significant differences between the two groups(P ＜0.05).The sizes of uterine leiomyoma were significantly reduced after the thermal ablation,the differences of volume within two groups in different time were statistics significance(P ＜0.05),but there were no statistics significance differences between two groups (P ＞0.05).The symptoms in two groups were improved significantly after treatment and the scores of UFS-QOL were no statistics significance differences between two groups (P ＞0.05).Conclusions Both of RFA and MWA have significant clinic efficiency in treating uterine leiomyoma.Compared with MWA,RFA with lower adverse reactions during operation and postoperation.
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Objective To evaluate the effect of 915 MHz microwave percutaneous coagulation of splenic artery injury in vivo experimental.Methods The manufacture model of the splenic artery injury were made and divided into two groups:group A (peripheral splenic artery injury) and group B (central type of splenic artery injury),915 MHz,2450 MHz microwave coagulation therapy and drug injections were performed under the guidance of ultrasound contrast.The hemostatic effect,operating time,total therapy time,amount of bleeding,amount of fluid infusion and histologic findings were compared.Results The treatment time of 915 MHz microwave[group A(4.65 ± 5.45),group B (9.38 ± 5.62) s] was less than those of 2450 MHz microwave[group A(86.36 ± 6.34) s,group B(127.72 ± 5.34) s] and drug injection [group A(128 ± 4.85)s,group B(182 ± 7.28)s],on the other hand,the amount of bleeding and fluid volume was less than that of rest methods.Conclusions Contrast-enhanced ultrasound guided 915 MHz microwave has significant hemostatic effect compared with the other two methods,915 MHz microwave percutaneous coagulation therapy has important significance to splenic artery injury in clinical.
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Objective To investigate the common complications of thermal ablations of liver cancer using both radiofrequency ablation (RFA) and microwave ablation (MWA) techniques,and compare the safety between these two procedures.Methods A total of 879 patients with hepatic tumors underwent thermal ablation.There were 323 cases having the RFA procedures and 556 cases having MWA procedures.The complications of thermal ablations of liver cancer were compared using both RFA and MWA techniques.Results A total of 1030 thermal ablation sessions was performed in 879 patients with a total of 1652 tumors.There were 323 patients with 562 tumors received a total of 376 RFA.The other 556 patients with 1090 tumors received a total of 654 MWA.The mortality rates were 0.31 ％ (1/323) and 0.36％ (2/556) in RFA and MWA group.In RFA and MWA group,the major complication rates were 3.5％ (13/376)and 3.1％ (20/654),meanwhile the minor complication rates were 5.9％ (22/376) and 5.7％ (37/654).There was no statistical significant difference for the mortality rates,the major complications,the minor complications between the RFA and MWA groups (P ＞0.05).Conclusions Thermal ablation therapy in the treatment of liver cancers is relatively safe with low mortality and low incidence of serious complications.The types and incidences of complications caused by RFA and MWA are similar and comparable for safety consideration in clinical settings.
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Objective To evaluate the hemostasis effect of 915 MHz microwave in the hepatic artery and portal vein injury in vivo dog liver.Methods After manufactured model of the hepatic artery and portal vein injury,915MHz microwave percutaneous coagulation therapy and drug injections were performed under the guidance of contrast-enhanced ultrasound (CEUS),the hemostatic effect,amount of bleeding and histologic findings were compared between the two groups.Results 915 MHz microwave coagulation had better hemostatic effect than drug injection,the amount of bleeding was significantly less than the injection method,and the pathological results showed that the vessel wall necrosis and surrounding tissue coagulation were more obvious than the injection.Conclusions CEUS guided 915 MHz microwave has a significant role in hemostasis,so the 915 MHz microwave percutaneous coagulation therapy of the hepatic artery and portal vein injury in vivo dog liver has important clinical auxiliary significance.
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Objective To explore the value of contrast-enhanced ultrasound (CEUS) in microwave ablation for brain tissues,and to provide experimental evidences for clinical application.Methods A total of 17 domestic dog brains underwent microwave ablation randomly at different output power and ablation duration.Ablation lesions were detected by conventional ultrasonography(US) and CEUS in half an hour after MA,the boundary and size of lesions were observed,then the morphology and parameters of timeintensity curve were compared among ablation area,edema area and normal area.Five hours after ablation,brain tissues were took out,morphology and microscope structure changes were observed.Results ① Thirty-four lesions were obtained after microwave ablation.By contrast with US,the size measured by CEUS was smaller,the difference was statistical( P =0.000).The size measured by CEUS proved to be accurate in the results of microscope pathology,and the brain lesions were necrosis completely in no enhancement area.②The parameters of time-intensity curve between edema zone and normal brain had no statistical difference( P =O.992,0.993,0.749),respectively.Conclusions The boundary of necrotic lesions was showed accurately in CEUS,meanwhile the perfusion of ablation zone and surrounding brain could be displayed clearly.CEUS could be used to assess the effect of microwave ablation.