Study of radiofrequency ablation treatment of adrenal malignant tumors by ultrasound-guided unipolar cooling cycle / 中华超声影像学杂志

ABSTRACT

Objective To analyze the efficacy and the safety of ultrasound guided multiple-spot sector stereotaxis in unipolar cooling cycle radiofrequency ablation treatment of adrenal malignant tumors.Methods 36 adrenocortical carcinoma primary or metastatic tumors were treated with ultrasound guided percutaneous radiofrequency ablation by the multiple spot sector stereotaxis in unipolar cooling cycle.All patients were performed contrast enchanced ultrasound (CEUS) 15 minutes after treatment to determine whether the tumors were completely inactivated,if did not completely inactivated based on the imaging,the same therapy can be repeated.To evaluate response,contrast-enhanced CT scans (CECT) or CEUS were obtained 1 month after the procedure,if did not completely inactivated,the same therapy can be repeated.Before and after the procedure,the blood cortisol,adrenocorticotropic hormone (ACTH) and sugar level were detected and compared respectively.Results The efficacyin the 36 lesions,31 lesions were inactivated and 5 lesions were residual by realtime CEUS.32 lesions were inactivated and 4 lesions were residual by CECT one month after the RFA therapy.There were no significant differences between the two groups(x2 =0.127,P =0.722).The hormone levelthe blood cortisol,ACTH and sugar level were recovered normal after the therapy.The complication and adverse reaction①Painall the patients felt slight pain and thermal expasion of the ablation region,among them,19 patients felt obvious pain were relieved after using analgesic.② Fluctuation of heart rate14 patients' heart rate were slowed down,it was reached to 25-55 beats per minute,0.5mg atropine was given by intravenous injection to make the heart rate return to normal.③ Fluctuation of bloodpressure9 patients' bloodpressure were elevated in the procedure,systolic pressure was 21-28 kPa,diastolic pressure was 13-19 kPa,5 mg nicardipine was given then relieved.There was no serious complication and dead cases in all the patients.Conclusions RFA is a safe and effective procedure for the treatment of adrenal malignant tumors and has great value in clinic applications.