title: Bile Duct Injury after Irreversible Electroporation  of Hepatic Malignancies: Evaluation of MR  Imaging Findings and Laboratory Values.
abstract: OBJECTIVE
  To evaluate biliary complications after irreversible electroporation (IRE) of hepatic malignancies.
  
  
  METHODS
  In 24 patients (17 men; mean age, 59.3 y), bile ducts were located within a 1.0-cm radius of the ablation zone at subacute follow-up (ie, 1–3 d) after percutaneous IRE of 53 hepatic tumors (primary hepatic tumors, n = 14). MR imaging, conducted with a hepatocyte-specific contrast agent before and after treatment, was examined for evidence of bile duct injury. Serum bilirubin and alkaline phosphatase levels measured at subacute and short-term follow-up (ie, 1–2 mo after IRE) were analyzed for evidence of biliary injury. Correlations between bile duct injury and characteristics of patients, lesions, and ablation procedures were assessed by generalized linear models.
  
  
  RESULTS
  Fifty-five bile ducts were located within 1.0 cm of an ablation defect. Locations relative to the ablation area were as follows: 33 were encased, 14 were abutting, and 8 were located within a radius of 0.1–1.0 cm of the ablation zone. Subacute follow-up MR images showed 15 bile duct injuries (narrowing, n = 8; dilation, n = 7). At subacute follow-up, three patients showed transient abnormalities of laboratory values (bilirubin, 1.6–5.2 mg/dL). Short-term laboratory values were abnormal in one patient (increase in alkaline phosphatase of 533 U/L vs baseline) as a result of local tumor recurrence. Patient age (continuous, P = .026; < 65 y vs ≥ 65 y, P = .001) was independently associated with post-IRE bile duct injury.
  
  
  CONCLUSIONS
  Bile ducts adjacent to an IRE ablation area remain largely unaffected by this procedure.
authors.forename: Marco
authors.initials: M
authors.lastname: Dollinger
authors.forename: Florian
authors.initials: F
authors.lastname: Zeman
authors.forename: Christoph
authors.initials: C
authors.lastname: Niessen
authors.forename: Sven A
authors.initials: SA
authors.lastname: Lang
authors.forename: Lukas P
authors.initials: LP
authors.lastname: Beyer
authors.forename: Martina
authors.initials: M
authors.lastname: Müller
authors.forename: Christian
authors.initials: C
authors.lastname: Stroszczynski
authors.forename: Philipp
authors.initials: P
authors.lastname: Wiggermann
mesh_terms: D055011:Ablation Techniques / Q000009:adverse effects*; D000328:Adult; D000368:Aged; D001649:Bile Duct Diseases / Q000209:etiology* / Q000473:pathology*; D001652:Bile Ducts / Q000473:pathology*; D003287:Contrast Media; D018274:Electroporation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007089:Image Enhancement; D008113:Liver Neoplasms / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D003287:Contrast Media