High-intensity focused ultrasound ablation in hepatic and pancreatic cancer: complications
High-intensity focused ultrasound ablation in hepatic and pancreatic cancer: complications
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DOI：
10.1007/s00261-010-9628-2
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发表时间：
2011-04-01
影响因子：
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通讯作者：
Han, Joon-Yeol
中科院分区：
文献类型：
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作者：
Jung, Seung Eun;Cho, Se Hyun;Han, Joon-Yeol
目的：探讨高强度聚焦超声（HIFU）治疗肝、胰腺癌的并发症。材料与方法：从2006年1月至2008年12月，在全麻下对114例原发性肝肿瘤（n = 57）、肝转移瘤（n = 22）和胰腺癌（n = 35）患者进行了133次HIFU治疗。使用体外超声引导的Model-JC系统（HAIFU，Chongqing，China）。在53例患者中，人工胸腔积液是为了获得足够的超声窗口以消融肝穹隆肿块。我们回顾了HIFU治疗前、治疗中和治疗后的医疗记录和影像学表现。结果：所有患者治疗部位均出现皮肤红肿、水肿、疼痛。所有肝肿瘤患者均发生沿主超声束路径的肋骨沿着坏死，无需进一步治疗。主要并发症包括胆道梗阻、症状性胸腔积液、气胸和腹壁脓肿与消融的肝肿瘤之间的瘘形成。在35名胰腺癌患者中，主要并发症包括三度烧伤和肿瘤与十二指肠之间的瘘形成。肝肿瘤患者的迟发性并发症包括沿超声路径的血管破裂和肋骨骨折沿着。结论：HIFU的并发症主要发生在靶病灶周围或沿着超声束路径。认识HIFU可能的并发症及其影像学特点，对避免严重并发症的发生至关重要。
Purpose: To evaluate the complications of high-intensity focused ultrasound (HIFU) in patients with hepatic and pancreatic cancer. Materials and Methods: From January 2006 to December 2008, 133 sessions of HIFU treatment were performed in 114 consecutive patients with primary hepatic tumor (n = 57), hepatic metastasis (n = 22), and pancreatic cancer (n = 35) under general anesthesia. The extracorporeal, ultrasound-guided Model-JC system (HAIFU, Chongqing, China) was used. Artificial pleural effusion was created to obtain an adequate sonographic window for ablating hepatic dome masses in 53 patients. We reviewed medical records and imaging findings before, during, and after HIFU. Results: All patients had skin redness, edema, and pain in the treatment regions. All hepatic tumor patients had necrosis of the ribs along the main ultrasound beam path that did not require further treatment. Major complications included biliary obstruction, symptomatic pleural effusion, pneumothorax and fistula formation between an abdominal wall abscess and the ablated hepatic tumor. In 35 pancreatic cancer patients, major complications included third-degree burns and fistula formation between the tumor and duodenum. Delayed complications in hepatic tumor patients included a diaphragmatic rupture and rib fractures along the ultrasound pathway. Conclusion: The complications of HIFU develop mainly around the targeted lesions or along the ultrasound beam pathway. It is essential to have awareness of the possible complications related to HIFU and its imaging features for to avoiding serious complications.