Figure - available from: BMC Cardiovascular Disorders
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Chest x-ray showing cardiomegaly and left pleural effusion during chest pain (a) and decreased heart size and left pleural effusion 3 days later (b)
Source publication
Background:
Radiofrequency ablation is a common and minimally invasive procedure used to treat liver tumors. However, the potential threat of heat injury to adjacent structures if the hepatic lesion is near the diaphragm is often overlooked and misunderstood. Rare cardiovascular complications have been reported. How best to identify the patients a...
Citations
... Image-guided thermal ablation is widely used in the local treatment of malignant liver tumors due to its minimal invasiveness and definite curative effect [1,2]. In the treatment of hepatic malignant tumors of segment II and IVa abutting the heart, thermal ablation has a risk of causing diaphragmatic perforation, cardiac tamponade, pericarditis, arrhythmia, and severe cases that can lead to death [3][4][5]. Currently, ultrasound (US) and computed tomography (CT) are most commonly used to guide liver tumor ablation. However, due to the interference of gas at the bottom of the lung, liver tumors at the top of the diaphragm often become blind spots for ablation treatment [6]. ...
Objective
This study aimed to evaluate the clinical safety and efficacy magnetic resonance (MR)-guided percutaneous thermal ablation for the treatment of small liver malignant tumors of segment II and IVa (≤3.0 cm) abutting the heart.
Method
The enrollment of 24 patients with 25 malignant liver lesions located on the II or IVa segment abutting the heart who underwent MRI-guided thermal ablation between August 2010 and February 2020 were retrospectively analyzed. Follow-up MRI was performed to evaluate the curative effect. Local tumor progression-free survival and overall survival rates were also calculated.
Results
The procedures including radiofrequency ablation (RFA) for 15 patients and microwave ablation (MWA) for 9 patients were successfully accomplished (technical success rate of 100%) without major complications. The mean duration time was 78.4 ± 29.4 min (40–140 min), and mean follow-up time was 31.5 ± 22.2 months (6–92 months). The technical efficacy was 100% following one ablation session with MRI assessment after one month. Local tumor progression was observed in one patient with a metastatic lesion located in segment II at 18 months follow-up. The progression-free survival time was 20.1 ± 16.9 months (median: 15 months). The 1-, 3-, and 5-year local tumor progression-free survival rates of this patient were 100%, 94.7%, and 94.7%, respectively. With regards to all the patients, the 1-, 3-, and 5-year estimated overall survival rates were 91.7%, 80.6%, and 50.1%, respectively.
Conclusion
MR-guided thermal ablation is safe and effective for the treatment of small liver malignant tumors located on the II or IVa segment abutting the heart.
