Ultrasonic monitoring of liver metastasis after radiofrequency thermoablation
Abstract
Introduction: To determine the possibility of ultrasound scanning for the choice of treatment methods and postoperative dynamic observation of patients with colorectal liver metastases.to determine the possibility of ultrasound scanning for the choice of treatment methods and postoperative dynamic observation of patients with colorectal liver metastases. Methods: In our clinic since 2014, radiofrequency thermoablation (RFT) of colorectal liver metastases was performed in 44 patients aged 47 to 75 years. There were 30 men (68.2%), women - 14 (31.8%) people. Most often noted bilobar liver damage, the tumors were intraparenchymatous. The metastases varied from 1 to 4 cm in diameter. Electrosurgical apparatus for radiofrequency ablation of Valleylab Cool-Tip RF was used. Visualization of the process was provided by ultrasonic monitoring in real time. Ultrasound studies were carried out on GE Medical Systems Vivid 3, Logiq Book XP in B-mode and duplex scanning. Results: The algorithm for preoperative research consisted of a set of measures: ultrasound, MRI, biopsy followed by histological examination. To select the RFA method (percutaneous under ultrasound or intraoperative), ultrasound scanning was the determining factor. In 3 patients, RFT was performed intraoperatively in connection with the bilobar, subcapsular location of the foci. Ultrasonic monitoring was performed on the first, seventh and thirtieth days after the operation. Early studies (the first and seventh days) revealed complications after manipulation. Dynamic observation noted: on the first day - increased echogenicity of the liver; on the seventh - a marked increase in echogenicity, increased clarity of borders and a violation of blood flow in the foci. A month later, when visualizing the location of RFT, all patients noted a decrease in the size of the focus by 10-30%, a lack of blood flow in it. Conclusion: Ultrasound scanning should be considered the optimal screening method for monitoring patients after RFT for metastatic liver damage in the immediate postoperative period.