Computed tomography-guided transpulmonary radiofrequency ablation for hepatocellular carcinoma located in hepatic dome

瞄准：为了决定，执行计算断层摄影术(CT ) 的可行性为位于肝的屋顶的肝细胞癌(HCC ) 指导了 transpulmonary 射频脱离(RFA ) 。方法：有包括位于肝的屋顶的七个小瘤的 HCC 的七个病人的一个总数从 2004 年 4 月被对待到 2004 年 12 月。指导 CT 的 transpulmonary RFA 基于一个标准化精力协议用一个凉爽尖端的类型电极(电子学公司) 被执行。位于肝的屋顶的所有肿瘤不由平常的超声(美国) 是可检测的方法。损害直径从 15 ～ 27 公里。结果：RFA 在所有病人是技术上可行的。刺过程被执行两次或更少和全部的平均成就时间是 40.6 min。本地肿瘤控制在所有病人被完成。坏死直径从 25 ～ 35 公里。吝啬的后续时期是 9.6 (7-14 瞬间) 瞬间。在后续点没有本地复发。要求肋膜的排水的气胸是主要复杂并发症，它在七个病人(28.6%) 中的二个被观察。然而，它与胸引流管改善了，并且试管能在 2-3 d 以内被移开。没有另外的主要复杂并发症被观察。结论：指导 CT 的刺为位于几乎不由美国可检测的肝的屋顶的肿瘤的治疗是有用的，尽管气胸可以有时作为复杂并发症发生。在有在人工的胸膜渗漏方法不是适当的为胸膜的粘附的情况中，指导 CT 的 RFA 因此被认为是为位于肝的屋顶的 HCC 的其他的治疗。

AIM： To determine the feasibility of performing computed tomography （CT）-guided transpulmonary radiofrequency ablation （RFA） for hepatocellular carcinoma （HCC） located in the hepatic dome. METHODS： A total of seven patients with HCC comprising seven nodules located in the hepatic dome were treated from April 2004 to December 2004. CTguided transpulmonary RFA was performed using a cool-tip type electrode （Radionics Company） based on a standardized energy protocol. All tumors located in the hepatic dome were not detectable by the usual ultrasound （US） methods. The lesion diameters ranged from 15 to 27 mm. RESULTS： RFA was technically feasible in all the patients. The puncture procedure was performed twice or less and the total average performance time was 40.6 min. Local tumor control was achieved in all the patients. The necrosis diameter ranged from 25 to 35 mm. The mean follow-up period was 9.6 （7-14 mo） mo. There was no local recurrenceat the follow-up points. Pneumothorax requiring pleural drainage was the main complication, which was observed in two of the seven patients （28.6%）. However, it improved with chest drainage tube, and the tube could be removed within 2-3 d. No other major complications were observed. CONCLUSION： CT-guided puncture is useful for the treatment of tumors located in the hepatic dome which are hardly detectable by US, even though pneumothorax sometimes may occur as a complication. In the cases with adhesion in the pleura for which artificial pleural effusion methods are not appropriate, CT-guided RFA is thus considered to be an alternative treatment for HCC located in the hepatic dome.