Ultrasound-guided microwave ablation of fast-growing small-sized hepatic hemangiomas

Chernousov A.F., Karpova R.V., Levkin V.V., Pavlov Yu.V., Fominykh E.V., Mishin A.S.

Purpose. To evaluate the effectiveness of minimally invasive interventions under the control of ultrasound and X-ray television in the treatment of patients with fast growing small liver hemangiomas. Determine the most effective minimally invasive method of treating patients with fast-growing small-sized liver hemangiomas.

Materials and methods. The study included 54 patients with cavernous hemangiomas. Ultrasound-guided microwave ablation (MWA) was performed in 35 patients (out of 54), ultrasound-guided sclerotherapy – 8, embolization – 11. For sclerotherapy, 96% ethyl alcohol was used, for embolization – metal spirals of the Gianturco type. The volume of hemangiomas was assessed before and a year after minimally invasive methods of treating hemangiomas based on ultrasound and CT data.

Results. In 31 of 35 patients after MWA, there was an increase in body temperature, ALT and AST levels. A year after the MWA, according to instrumental methods of research, in areas of hemangiomas, areas of fibrosis without signs of vascularization were identified. Vascularization of hemangiomas was identified in 2 of 35 patients, requiring re-treatment. After sclerotherapy, in 2 of 8 patients, cessation of blood flow and a decrease in hemangiomas were noted. In the remaining 6 patients, hemangioma vascularization remained, the volume remained the same or increased. After embolization of hemangiomas, in 5 of 11 patients a volume reduction without signs of vascularization was diagnosed. The remaining patients had hemangiomas with signs of vascularization and an increase in volume. Complications during and after minimally invasive interventions, deaths were not.

Studies conducted a year after embolization and sclerotherapy of liver hemangiomas showed a relapse of the disease in 55% and 75%, respectively.

Conclusion. Ultrasound-guided MWA is the most effective minimally invasive method of treating fast-growing small-sized liver hemangiomas. High efficiency of this method is combined with the absence of complications and the possibility of re-use.

I.M. Sechenov First

Moscow State Medical University

Moscow, Russia

 

Keywords: microwave ablation, sclerotherapy, embolization, liver hemangioma.


Corresponding author:  Mishin A.S., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript

 

For citation: Chernousov A.F., Karpova R.V., Levkin V.V., Pavlov Yu.V., Fominykh E.V., Mishin A.S. Ultrasound-guided microwave ablation of fast-growing small-sized hepatic hemangiomas. REJR 2019; 9(1):102-107. DOI:10.21569/2222-7415-2019-9-1-102-107.

Received:        21.12.18 Accepted:       16.01.19