大于3cm肝癌302例射频消融 治疗策略及疗效【精品课件】.pptVIP

Contrast US showed the tumor still have viable tissue. We used bipolar electrodes to treat the viable tumor. One month CT showed no enhancement in treatment area. * However, for the tumors not suitable for TACE or recurrence after TACE, we set up a new method to block feeding vessels immediately before RF ablation. It was called percutaneous ablation feeding artery (PAA). This is PAA sketch. Additional 2-3 small ablations to ablate the entrance area of feeding artery to enhance the coagulation effect. This is a HCC Tumor. The size was 5.5x4.8 cm. Color US showed two feeding arteries in tumor. Color US guided ablated the entrance area of main feeding artery. Immediately after PAA, CEUS showed the main feeding artery was blocked, but there was another feeding artery above. We can see rim-like enhancement on CEUS. US guided PAA for the second feeding A. CEUS showed perfusion defection in the whole tumor. After PAA, we continued to abate other area of tumor. Follow up CT showed the ablation area had no enhancement. Our results showed tumor early necrosis rate was 92%. It was little lower for tumor 5cm but there was no significant difference. Long term outcome showed 5 and 7 year survival was lower in the large tumor group. The difference in survival between tumors with different sizes might be related to the more invasive behavior of larger HCC The major complication rate was 3.9% in this study. Our conclusion were, the strategy for tumor 3 cm can achieve a high success rate with a low complication rate and then benefit for survival. But the patients with 5 cm HCC tended have lower survival results, thus optimized multi-modalities treatment should be investigated for these tumors in the future. As one of the clinical trail center, we believe the important direction in local therapy will be the combination treatment. Target chemotherapy and thermal ablation would play essential role in this field. Post-second PAA Contrast US: The entire tumor perfusion defe