Zusammenfassung.
Ziel: Evaluation der Praktikabilität, Sicherheit und Effektivität der perkutanen Radiofrequenzablation
(RFA) hepatischer Neoplasien unter Verwendung von „Cluster”-Ablationssonden. Material und Methoden: In einer prospektiven Studie wurde bei 12 Patienten mit insgesamt 15 hepatischen
Neoplasien (2,0 - 6,0 cm Durchmesser) eine perkutane, CT-gesteuerte RFA mittels „Cluster”-Ablationssonde
durchgeführt. Ergebnisse: Insgesamt wurden 17 RFA mit der „Cluster”-Sonde durchgeführt. Bei einer durchschnittlichen
Gesamtinterventionszeit von 2,0 h (1,5 - 2,5 h) gelang die perkutane Positionierung
der Sonde unter lokaler Anästhesie in allen Fällen. Behandlungsbedürftige Komplikationen
oder technische Probleme traten nicht auf. Die Ablationszonen hatten einen Durchmesser
von 3,0 - 7,0 cm. Ein initialer technischer Ablationserfolg wurde bei 13 von 15 Neoplasien
(86,6 %) beobachtet. 8 von 12 Neoplasien zeigten in einem durchschnittlichen Nachbeobachtungszeitraum
von 7,25 Monaten (3 - 12 Monate) eine komplette Nekrose. Schlussfolgerung: Die perkutane RFA unter Verwendung von „Cluster”-Ablationssonden ist ein praktikables,
sicheres und effektives Verfahren zur minimal-invasiven Therapie hepatischer Neoplasien
einer Größe bis zu 6 cm.
Percutaneous Radiofrequency Ablation of Hepatic Neoplasms using a Clustered Electrode
- First Clinical Results.
Purpose: To evaluate feasibility, safety and efficacy of percutaneous radiofrequency ablation
(RFA) of hepatic neoplasms using a clustered electrode. Material and Methods: Percutaneous, CT-guided RFA using a clustered electrode was performed in 12 patients
with a total of 15 hepatic neoplasms (2.0 - 6.0 cm in diameter). Results: A total of 17 percutaneous RFA was performed. The mean total procedure time was 2.0
h (1.5 - 2.5 h). Placement of the clustered electrode within the neoplasms using a
inter- or subcostal approach under local anesthesia was possible in all cases. Complications
related to percutaneous treatment and technical problems were not encountered. Diameter
of the ablated areas ranged between 3.0 - 7.0 cm. Technical success was observed in
13 of 15 neoplasms (86.6 %). During a mean follow-up of 7.25 months (range 3 - 12
months) 8 of 12 neoplasms showed a complete necrosis. Conclusion: Percutaneous RFA using a clustered electrode is a feasible, safe and effective procedure
for the treatment of hepatic neoplasms up to 6 cm in size.
Schlüsselwörter:
Leber - Neoplasma - Radiofrequenz - Ablation
Key words:
Liver - Neoplasm - Radiofrequency - Ablation
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Dr. med. Jochen Trübenbach
Radiologische Klinik Radiologische Diagnostik Eberhard-Karls-Universität
Hoppe-Seyler-Str. 3
72076 Tübingen
Phone: + 49-7071-2982087
Fax: + 49-7071-295845
Email: jochen.truebenbach@med.uni-tuebingen.de