Computed tomography-guided radiofrequency ablation following transcatheter arterial embolization in treatment of large hepatic hemangiomas

doi:10.3877/cma.j.issn.2095-5782.2015.04.008

Abstract

Abstract:

Objective

The purpose of this study was to evaluate the feasibility, safety, and efficacy of computed tomography (CT)-guided radiofrequency (RF) ablation combined with transcatheter arterial embolization (TAE) to treat large (≥ 10 cm) hepatic hemangiomas.

Methods

We retrospectively reviewed our sequential experience with 15 large hepatic hemangiomas in 15 patients.

Results

The mean diameter of the 15 hemangiomas was (13.0±2.2) cm (10.0–16.0 cm). RF ablation combined with TAE treatment was performed successfully in all patients. The mean diameter of the hemangiomas decreased from (13.0±2.2) to (7.1±2.0) cm fter TAE treatment. Out of 15 hepatic hemangiomas, 14 (93.3%) showed no enhancement on CT or MRI indicating complete ablation after RF treatment. The mean diameter of the ablation zone decreased to (6.1±2.0) cm one month after ablation and further decreased to (4.9±1.6) cm six months after ablation. There were six complications related to the ablation in four patients. According to the Dindo–Clavien classification, all the complications were minor (Grade I).

Conclusions

RF ablation combined with TAE is a safe and effective treatment for large hepatic hemangiomas. TAE can improve the disruption of lesion blood supply and reduce lesion size to facilitate subsequent RF ablation and reduce the risk of ablation-related complications.

Key words: Hemangioma, Liver, Large, Radiofrequency Ablation, Embolization

Jingjing Song, Zhongwei Zhao, Jianfei Tu, Jiansong Ji, Jun Gao. Computed tomography-guided radiofrequency ablation following transcatheter arterial embolization in treatment of large hepatic hemangiomas[J]. Chinese Journal of Interventional Radiology(Electronic Edition), 2015, 03(04): 201-206.

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References 21

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特征		例（%）
合并症		?
?	慢性乙型肝炎	2(13.3)
?	糖尿病	1(6.7)
?	肝囊肿	3(20.0)
射频消融的原因		?
?	腹痛或不适	3(20.0)
?	血管瘤增大	4(26.7)
?	腹痛伴血管瘤增大	8(53.3)
血管瘤的位置		?
?	肝右叶	8(53.4)
?	肝左叶	2(13.3)
?	肝左、右叶	5(33.3)

特征		例（%）
合并症		?
?	慢性乙型肝炎	2(13.3)
?	糖尿病	1(6.7)
?	肝囊肿	3(20.0)
射频消融的原因		?
?	腹痛或不适	3(20.0)
?	血管瘤增大	4(26.7)
?	腹痛伴血管瘤增大	8(53.3)
血管瘤的位置		?
?	肝右叶	8(53.4)
?	肝左叶	2(13.3)
?	肝左、右叶	5(33.3)

参数	数值
碘油用量(ml)	14.3±3.1(10.0～20.0)
TAE治疗后住院时间(d)	2.2±0.9(1～3)
TAE治疗1月后的平均直径(cm)	7.1±2.0(5～10)
消融穿刺次数	5.5±1.1(4～7)
消融时间(min)	59.2±12.0(45～80)
RFA术后住院时间(d)	3.0±1.0(3～5)
RFA术后1月消融灶直径(cm)	6.1±2.0(4～9)
RFA术后6月消融灶直径(cm)	4.9±1.6(3～7)

参数	数值
碘油用量(ml)	14.3±3.1(10.0～20.0)
TAE治疗后住院时间(d)	2.2±0.9(1～3)
TAE治疗1月后的平均直径(cm)	7.1±2.0(5～10)
消融穿刺次数	5.5±1.1(4～7)
消融时间(min)	59.2±12.0(45～80)
RFA术后住院时间(d)	3.0±1.0(3～5)
RFA术后1月消融灶直径(cm)	6.1±2.0(4～9)
RFA术后6月消融灶直径(cm)	4.9±1.6(3～7)

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