BACKGROUND: The traditional therapy for hepatic cysts has limited success because of recrudescence. Radiofrequency ablation (RFA) has become popular because of its advantages including little damage, therapeutic effec...BACKGROUND: The traditional therapy for hepatic cysts has limited success because of recrudescence. Radiofrequency ablation (RFA) has become popular because of its advantages including little damage, therapeutic effect and reduced suffering. This report describes the effects and reliability of RFA in the treatment of 29 patients with hepatic cysts. METHODS: B-ultrasound-guided REA was used to treat hepatic mono-cyst or multi-cysts of 29 patients (63 tumors). Ablative efficiency and complications were assessed by imaging and clinical symptoms. RESULTS: The tumors were abated completely in 34 cysts with a diameter <5 cm and no recurrence was seen after 3 months. In 21 cysts with a diameter of 5-10 cm, tumor volume was decreased by over 70%, then reduction and fiberosis were found. In 8 cysts with a diameter greater than 10 cm, tumor volume was decreased by more than 60%, and in 2 cysts it was increased more slightly than that at I month after REA. In subsequent follow-up (6 and 12 months after REA), tumors <10 cm in diameter were fully ablated. No significant discomfort and complications were found in any patient. CONCLUSION: RFA for the treatment of hepatic cysts is safe, and free from complications.展开更多
AIM: To evaluate the feasibility of using therapeutic ultrasound as an alternative treatment option for organconfined prostate cancer. METHODS: In this study, a trans-urethral therapeutic ultrasound applicator in comb...AIM: To evaluate the feasibility of using therapeutic ultrasound as an alternative treatment option for organconfined prostate cancer. METHODS: In this study, a trans-urethral therapeutic ultrasound applicator in combination with 3T magnetic resonance imaging(MRI) guidance was used for realtime multi-planar MRI-based temperature monitoring and temperature feedback control of prostatic tissue thermal ablation in vivo. We evaluated the feasibility and safety of MRI-guided trans-urethral ultrasound to effectively and accurately ablate prostate tissue while minimizing the damage to surrounding tissues in eight canine prostates. MRI was used to plan sonications, monitor temperature changes during therapy, and to evaluate treatment outcome. Real-time temperature and thermal dose maps were calculated using the proton resonance frequency shift technique and were displayed as two-dimensional color-coded overlays on top of the anatomical images. After ultrasound treatment, an evaluation of the integrity of cavernosal nerves was performed during prostatectomy with a nerve stimulator that measured tumescence response quantitatively and indicated intact cavernous nerve functionality. Planned sonication volumes were visually correlated to MRI ablation volumes and corresponding histo-pathological sections after prostatectomy. RESULTS: A total of 16 sonications were performed in 8 canines. MR images acquired before ultrasound treatment were used to localize the prostate and to prescribe sonication targets in all canines. Temperature elevations corresponded within 1 degree of the targeted sonication angle, as well as with the width and length of the active transducer elements. The ultrasound treatment procedures were automatically interrupted when the temperature in the target zone reached 56 ℃. In all canines erectile responses were evaluated with a cavernous nerve stimulator post-treatment and showed a tumescence response after stimulation with an electric current. These results indicated intact cavernous nerve functionality. In all specimens, regions of thermal ablation were limited to areas within the prostate capsule and no damage was observed in periprostatic tissues. Additionally, a visual analysis of the ablation zones on contrast-enhanced MR images acquired post ultrasound treatment correlated excellent with the ablation zones on thermal dose maps. All of the ablation zones received a consensus score of 3(excellent) for the location and size of the correlation between the histologic ablation zone and MRI based ablation zone. During the prostatectomy and histologic examination, no damage was noted in the bladder or rectum.CONCLUSION: Trans-urethral ultrasound treatment of the prostate with MRI guidance has potential to safely, reliably, and accurately ablate prostatic regions, while minimizing the morbidities associated with conventional whole-gland resection or therapy.展开更多
目的分析B超协助引导下微创经皮肾镜取石术(MPCNL)治疗肾结石的临床疗效以及出血并发症的诱发因素。方法选择2013年7月~2016年6月于笔者医院住院治疗的160例肾结石患者,随机分为对照组(开放手术取石)和观察组(B超引导下经皮肾镜取石),...目的分析B超协助引导下微创经皮肾镜取石术(MPCNL)治疗肾结石的临床疗效以及出血并发症的诱发因素。方法选择2013年7月~2016年6月于笔者医院住院治疗的160例肾结石患者,随机分为对照组(开放手术取石)和观察组(B超引导下经皮肾镜取石),各80例;记录并比较两组患者手术时间、出血量、并发症发生率、住院时间、结石清除率,采用Logistic多因素回归分析法研究出血影响因素。结果与对照组比较,观察组患者手术时间显著缩短(0.98±0.13 vs 2.16±0.80h)、出血量显著降低(120.6±37.5 vs 591.7±102.4ml):并发症发生率显著降低[2.5%(2/80)vs 17.5%(14/80)]、平均住院时间显著缩短(9.5±2.1 vs 21.7±3.4天),差异均有统计学意义(P<0.05);两组患者结石清除率比较,差异无统计学意义(P>0.05)。Logistic多因素回归分析结果显示,MPCNL治疗肾结石出血与手术时间、结石类型、糖尿病、肾功能不全及泌尿系感染等因素密切相关。结论 B超引导下MPCNL治疗肾结石疗效确切且具有手术时间短、并发症发生率低、出血量少等优势。为进一步降低出血风险,应关注糖尿病、肾功能、结石类型以及泌尿系感染等因素。展开更多
文摘BACKGROUND: The traditional therapy for hepatic cysts has limited success because of recrudescence. Radiofrequency ablation (RFA) has become popular because of its advantages including little damage, therapeutic effect and reduced suffering. This report describes the effects and reliability of RFA in the treatment of 29 patients with hepatic cysts. METHODS: B-ultrasound-guided REA was used to treat hepatic mono-cyst or multi-cysts of 29 patients (63 tumors). Ablative efficiency and complications were assessed by imaging and clinical symptoms. RESULTS: The tumors were abated completely in 34 cysts with a diameter <5 cm and no recurrence was seen after 3 months. In 21 cysts with a diameter of 5-10 cm, tumor volume was decreased by over 70%, then reduction and fiberosis were found. In 8 cysts with a diameter greater than 10 cm, tumor volume was decreased by more than 60%, and in 2 cysts it was increased more slightly than that at I month after REA. In subsequent follow-up (6 and 12 months after REA), tumors <10 cm in diameter were fully ablated. No significant discomfort and complications were found in any patient. CONCLUSION: RFA for the treatment of hepatic cysts is safe, and free from complications.
基金The National Cancer Institute Education and Career Development program R25 Cancer Nanotechnology in Imaging and Radiotherapy(5R25CA132822-04)in partthe Cancer Research Foundation+1 种基金the University of Chicago Comprehensive Cancer CenterPhilips Healthcare
文摘AIM: To evaluate the feasibility of using therapeutic ultrasound as an alternative treatment option for organconfined prostate cancer. METHODS: In this study, a trans-urethral therapeutic ultrasound applicator in combination with 3T magnetic resonance imaging(MRI) guidance was used for realtime multi-planar MRI-based temperature monitoring and temperature feedback control of prostatic tissue thermal ablation in vivo. We evaluated the feasibility and safety of MRI-guided trans-urethral ultrasound to effectively and accurately ablate prostate tissue while minimizing the damage to surrounding tissues in eight canine prostates. MRI was used to plan sonications, monitor temperature changes during therapy, and to evaluate treatment outcome. Real-time temperature and thermal dose maps were calculated using the proton resonance frequency shift technique and were displayed as two-dimensional color-coded overlays on top of the anatomical images. After ultrasound treatment, an evaluation of the integrity of cavernosal nerves was performed during prostatectomy with a nerve stimulator that measured tumescence response quantitatively and indicated intact cavernous nerve functionality. Planned sonication volumes were visually correlated to MRI ablation volumes and corresponding histo-pathological sections after prostatectomy. RESULTS: A total of 16 sonications were performed in 8 canines. MR images acquired before ultrasound treatment were used to localize the prostate and to prescribe sonication targets in all canines. Temperature elevations corresponded within 1 degree of the targeted sonication angle, as well as with the width and length of the active transducer elements. The ultrasound treatment procedures were automatically interrupted when the temperature in the target zone reached 56 ℃. In all canines erectile responses were evaluated with a cavernous nerve stimulator post-treatment and showed a tumescence response after stimulation with an electric current. These results indicated intact cavernous nerve functionality. In all specimens, regions of thermal ablation were limited to areas within the prostate capsule and no damage was observed in periprostatic tissues. Additionally, a visual analysis of the ablation zones on contrast-enhanced MR images acquired post ultrasound treatment correlated excellent with the ablation zones on thermal dose maps. All of the ablation zones received a consensus score of 3(excellent) for the location and size of the correlation between the histologic ablation zone and MRI based ablation zone. During the prostatectomy and histologic examination, no damage was noted in the bladder or rectum.CONCLUSION: Trans-urethral ultrasound treatment of the prostate with MRI guidance has potential to safely, reliably, and accurately ablate prostatic regions, while minimizing the morbidities associated with conventional whole-gland resection or therapy.
文摘目的分析B超协助引导下微创经皮肾镜取石术(MPCNL)治疗肾结石的临床疗效以及出血并发症的诱发因素。方法选择2013年7月~2016年6月于笔者医院住院治疗的160例肾结石患者,随机分为对照组(开放手术取石)和观察组(B超引导下经皮肾镜取石),各80例;记录并比较两组患者手术时间、出血量、并发症发生率、住院时间、结石清除率,采用Logistic多因素回归分析法研究出血影响因素。结果与对照组比较,观察组患者手术时间显著缩短(0.98±0.13 vs 2.16±0.80h)、出血量显著降低(120.6±37.5 vs 591.7±102.4ml):并发症发生率显著降低[2.5%(2/80)vs 17.5%(14/80)]、平均住院时间显著缩短(9.5±2.1 vs 21.7±3.4天),差异均有统计学意义(P<0.05);两组患者结石清除率比较,差异无统计学意义(P>0.05)。Logistic多因素回归分析结果显示,MPCNL治疗肾结石出血与手术时间、结石类型、糖尿病、肾功能不全及泌尿系感染等因素密切相关。结论 B超引导下MPCNL治疗肾结石疗效确切且具有手术时间短、并发症发生率低、出血量少等优势。为进一步降低出血风险,应关注糖尿病、肾功能、结石类型以及泌尿系感染等因素。
