Radiofrequency ablation for hepatocellular carcinoma abutting the diaphragm: the value of artificial ascites.
Ultrasound (US)-guided percutanoeus radiofrequency (RF) ablation is difficult to perform for treating a hepatic tumor abutting the diaphragm due to a poor sonic window and high risk of diaphragmatic thermal injury. RF ablation with assistance of the use of artificial ascites is a simple and safe technique for treating a hepatic dome tumor abutting the diaphragm. One can improve the sonic window and separate the RF ablation zone from the diaphragm by downward displacement of the liver with the use of a simple and inexpensive technique. Dextrose water solution is an ideal fluid due to its nonionic nature. Complications related to the use of artificial ascites including hemoperitoneum are rare. Peritoneal adhesion and tumor location in the bare area are the limitations for the application of this technique.
Rhim
Hyunchul
H
Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam-Gu, Seoul, Korea. rhimhe@skku.edu
Lim
Hyo K
HK
D001201:Ascites / Q000000981:diagnostic imaging; D002056:Burns / Q000517:prevention & control; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D003287:Contrast Media; D003964:Diaphragm / Q000000981:diagnostic imaging / Q000293:injuries; D005240:Feasibility Studies; D005947:Glucose; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D011856:Radiographic Image Enhancement / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods; D018084:Ultrasonography, Interventional / Q000379:methods
D003287:Contrast Media; D005947:Glucose