ObjectiveTo investigate efficacy and safety of three-step radiofrequency ablation (RFA) in treatment for giant hepatic hemangioma (GHH,diameter ≥5 cm) with symptoms. MethodsThe patients with GHH met the inclusion criteria were collected.The main steps were as follows:The first step was to destroy the main arteries of the tumor to block the blood.The second step was to withdraw the blood of the tumor to shrink the tumor.The third step was to damage the shrunk tumor by RFA. ResultsThere were 13 patients with GHH met the inclusion criteria.The median preoperative diameter was 8.0 cm.The median volume of withdrawing blood was 78 mL.The median diameter after withdrawing blood was 5.3 cm.The diameters between after and before withdrawing blood had a significant difference (P<0.01).The time for damaging tumor blood supply was (4.4±1.0) min.The median frequency of tumor RFA was 4 times.The median time of tumor RFA was 16 min.The median time of total operation was 20 min.There were 3 cases of tumor residual after RFA,10 cases were met full damage,and the damage rate was 85.9%-100% with an average of 97.0%.The hospital stay after RFA was (3.9±1.2) d.One case was remission after conservative treatment because of complication. ConclusionThe preliminary results of limited cases in this study show that three-step RFA for GHH is effective and safe,but it needs to be researched for large samples data.
Objective To determine feasibility of texture analysis of non-enhanced CT scan for differential diagnosis of liver cancer and hepatic hemangioma. Methods Fifty-six patients with liver cancer or hepatic hemangioma confirmed by pathology were enrolled in this retrospective study. After exclusion of images of 4 patients with artifacts and lesion diameter less than 1.0 cm, images of 52 patients (57 lesions) were available to further analyze. Texture features derived from the gray-level histogram, co-occurrence and run-length matrix, absolute gradient, autoregressive model, and wavelet transform were calculated. Fisher, probability of classification error and average correlation (POE+ACC), and mutual information coefficients (MI) were used to extract 10 optimized texture features. The texture characteristics were analyzed by using linear discriminant analysis (LDA) and nonlinear discriminant analysis (NDA) provided by B11 module in the Mazda software, the minimum error probability of differential diagnosis of liver cancer and hepatic hemangioma was calculated. Most discriminating features (MDF) of LDA was applied to K nearest neighbor classification (KNN); NDA to extract the data used in artificial neural network (ANN) for differential diagnosis. Results The NDA/ANN-POE+ACC was the best for identifying liver cancer and hepatic hemangioma, and the minimum error probability was the lowest as compared with the LDA/KNN-Fisher, LDA/KNN-POE+ACC, LDA/KNN-MI, NDA/ANN-Fisher, and NDA/ANN-MI respectively, the differences were statistically significant (χ2=4.56, 4.26, 3.14, 3.14, 3.33;P=0.020, 0.018, 0.026, 0.026, 0.022). Conclusions The minimum error probability is low for different texture feature selection methods and different analysis methods of Mazda texture analysis software in identifying liver cancer and hepatic hemangioma, and NDA/ANN-POE+ACC method is best. So it is feasible to use texture analysis of non-enhanced CT images to identify liver cancer and hepatic hemangioma.
Radiofrequency ablation for hepatic hemangioma is safe and effective, and can obtain the same curative effect as traditional surgical resection. For hepatic hemangiomas with large volume, abundant arterial blood supply and long ablation time, systemic inflammatory response syndrome (SIRS) often occurs after radiofrequency ablation, which can lead to injury or dysfunction of important organs. This paper systematically summarizes the mechanism, prevention and treatment of SIRS after radiofrequency ablation of hepatic hemangioma, so as to provide reference for improving the safety of radiofrequency ablation of hepatic hemangioma.