Feasibility, safety, and efficacy of ultrasound-guided percutaneous microwave ablation for giant hepatic hemangioma

Figures & data

Table 1. Information on the 12 cases of patients with giant hemangiomas.

No.	Gender (female/male)	Age (years)	Treatment before (1 – Yes/2 – No)	Reasons for MWA (A*, B**)	Planned sessions of ablation	Number of hemangiomas	Preablation largest diameter (cm)	Location of the largest hemangioma	Ablation time (min)	Mean power (W)	Post-ablation largest diameter (cm)	Initial complete ablation (1 – Yes/2 – No)	Total complete ablation (1 – Yes/2 – No)	Discomfort and complications***
1	Female	41	2	A	2	2	11	Hepatic area near the top of the diaphragm	55	80	8.7	1	1	5,7
									24	80
2	Male	32	2	B	2	2	14.5	Liver parenchyma	62	80	10.1	1	1	1,5,7,8
									31	80
3	Female	67	2	B	2	1	13	Liver parenchyma	33	80	10.8	1	1	1,3,5,7
									30	80
4	Male	35	2	B	1	1	10.5	Liver parenchyma	39	80	9.5	2	1	2,3,5,7
5	Female	45	2	A	1	1	10	Hepatic area near the top of the diaphragm	41	80	5	2	2	2,3,5,6,7
6	Female	35	2	B	1	1	14.3	Liver parenchyma	57	80	6.9	1	1	2,7
7	Female	38	2	B	1	3	10	Liver parenchyma	26.5	80	6.7	1	1	6,7,8
8	Male	44	2	B	1	1	11	Liver parenchyma	20	80	8	1	1	5,7
9	Female	31	2	A	1	2	12.5	Near the intestinal tract	62	80	8	2	2	2,5,6,7
10	Female	52	2	A,B	1	1	10	Liver parenchyma	30	80	8	1	1	3,4,6,7
11	Male	40	2	B	1	3	11	Liver parenchyma	30.5	80	8	1	1	7
12	Female	37	1	A,B	2	2	12.5	Liver parenchyma	55	80	7.1	1	1	5
							11.7	Liver parenchyma	28	80	7.5	1	1	7

* A: the patients had obvious symptoms, such as abdominal pain, anemia, bleeding, hemorrhage, jaundice, thrombocytopenia, and hyperfibrinogenemia, or had serious mental burden caused by hemangiomas.

** B: the hemangiomas of the patients tended to enlarge (enlarged more than 0.5 cm within one year).

*** 1 – low fever (≥38 °C); 2 – constipation; 3 – slight wound pain; 4 – stomach discomfort; 5 – high bilirubin (total bilirubin >34.2 mmol/L); 6 – anemia (hemoglobin <100 g/L); 7 – elevated serum transaminase (>80 U/L); 8 – elevated serum creatinine (absolute elevated values ≥26.4 µmol/L within 48 h or increased ≥50% above baseline values).

Figure 1. Needle placement description.

Table 2. Discomfort and complications after MWA for 13 giant hemangiomas.

Discomfort and complications	13 giant hemangiomas
Low fever (≥38 °C)	2 (15.4%)
Constipation	4 (30.8%)
Slight wound pain	4 (30.8%)
Stomach discomfort	1 (7.7%)
High bilirubin (total bilirubin >34.2 mmol/L)	7 (53.8%)
Anemia (hemoglobin <100 g/L)	4 (30.8%)
Elevated serum transaminase (>80 U/L)	13 (100.0%)
Elevated serum creatinine (absolute elevated values ≥26.4 µmol/L within 48 h or increased ≥50% above baseline values)	2 (15.4%)

Table 3. Liver function changes after ablation.

Indexes	Post-ablation	First day post-ablation	p-value*
Alb	45.0 ± 3.4	38.1 ± 4.4	<.001
ALT	20.4 ± 14.3	267.7 ± 205.3	<.001
AST	17.6 ± 5.5	491.2 ± 336.3	<.001
TB	8.8 ± 2.7	39.6 ± 18.3	<.001
DB	3.4 ± 1.0	13.5 ± 12.4	.006

* p-values were calculated using paired T-test.

Figure 2. A 67-year-old female with a giant hepatic hemangioma of 13 cm in diameter. (A) Preoperative MRI (size: 13 cm × 9 cm). (B) MRI after the first ablation (size: 8 cm × 7 cm). (C) MRI after the second ablation (size: 10.8 cm × 7.8 cm).

Figure 3. A 37-year-old male with two giant hepatic hemangiomas of 12.5 and 11.7 cm in diameter. (A) Preoperative MRI (size: 12.5 cm × 10.0 cm, 11.7 cm × 9.3 cm). (B) MRI after the first ablation (size: 7.5 cm ×6.2 cm). (C) MRI after the second ablation (size: 7.1 cm × 6.4 cm).