Résumé
ObjectiveTo assess the safety and efficacy of contrast-enhanced ultrasound (CEUS)-guided percutaneous microwave ablation (MWA) treatment of renal carcinomas.MethodsFifteen patients with 17 renal tumors were retrospectively analyze. The patients’ ages were in the range of 46-80 years (65.2±9.4 years), the tumor diameters were in the range of 1.1-3.9 cm (2.3±0.7 cm) and biopsy pathological results were renal cell carcinoma. All of the tumors were inconspicuous on conventional ultrasound, while conspicuous on contrast enhanced-computed tomography (CT) or magnetic resonance imaging (MRI). Seventeen tumors were ablated under the guidance of CEUS.ResultsAll tumors were successfully visualized on CEUS and MWA was performed under CEUS guidance. The durations of energy application for each tumor were in the range of 5-11 min (mean± SD 7.3±2.2 min). The mean session of CEUS-guided MWA for each tumor was 1.1±0.3. All patients were followed up for 3-49 months (median, 17 months) to observe the therapeutic effects and complications. There was no local tumor progress and major complication. ConclusionCEUS-guided PMWA is a safety, efficient and feasible therapy for patients with RCC which is inconspicuous on conventional US.
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Objective To evaluate low-mechanical-index contrast-enhanced ultrasound (CEUS) in assessing the clinical efficacy and feasibility of percutaneous microwave ablation (MWA) for the treatment of renal cell carcinoma (RCC). Methods From March 2006 to July 2013, a total of 105 RCC patients with 109 lesions, mean size being (3.1 ± 1.3) cm, were treated with ultrasound-guided percutaneous MWA. CEUS results obtained on the third day after MWA were compared with the contrast-enhanced CT/MRI and biopsy findings in the corresponding period. Follow-up examinations with CEUS and CT/MRI were carried out 1, 3 and 6 months after the treatment and once every 6 months thereafter to evaluate the short-term and the long-term therapeutic effectiveness. Results Three days after MWA, CEUS showed that 94 of 109 lesions (86.2%) were completely ablated, and residual tumor tissue was seen in 15 of 109 lesions (13.8%). Among the 15 lesions with residual tumor tissue, 13 (86.7%) were proved by contrast-enhanced CT/MRI and/or biopsy performed in the corresponding period. The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of CEUS for the evaluation of the short-term MWA effectiveness were 100%, 97.9%, 98.2%, 86.7% and 100%, respectively. Patients were followed up for 3 - 90 months with a median period of 24.6 months. During the follow - up period, CEUS detected recurrence in 7 patients, and 6 of them were consistent with CT/MRI results. The sensitivity, specificity, accuracy, positive and negative predictive value of CEUS for the evaluation of the long-term MWA effectiveness were 85.7%, 99.0%, 98.2%, 85.7% and 99.0%, respectively. Conclusion For the evaluation of the effectiveness of percutaneous microwave ablation in treating renal cell carcinoma, CEUS is a sensitive, reliable and convenient technique.
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OBJECTIVE The two kinds of condition of infection on operation cuts because of different ways of skin preparation. METHODS Divide 530 patients of common surgery into two groups as casual: experiment group and comparison group. For experiment group, the method of using 2 h to clean the skin without shaving is chosen before operation, for comparison, taking the method of using 1 d and shaving. The culture of bacteria from the skin is done respectively before operation sterilization and the infection rate of operation cuts is found out. RESULTS The rate of bacteria and infection rate of operation cuts of experiment group are quite below those of the comparison group. CONCLUSIONS The method of using 2 h without shaving to clean the operation cuts is much better than that of using 1 d and shaving.