多方向アクセスによるMRガイド下肝腫瘍マイクロ波凝固療法

概要

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Microwave Ablation is one of the useful treatments of hepatic tumor. It has been used as an interventional device for thermoablation therapy under ultrasonographic or laparoscopic guidance. We have done clinical studies of MR-guided microwave ablation therapy of hepatic tumors since January 2000. From January through September 2000, 18 patients with liver tumors were hospitalized in the 1st Department of Surgery at Shiga University of Medical Science. There were 13 cases of metastatic hepatic tumor. All of which had previously had primary surgery. The other 5 cases were primary hepatic cancer. All patients were selected because percutaneous ethanol injection therapy (PEIT) or transcathetal arterial embolization (TAE) was ineffective, and surgical resection could not be done because of hepatic dysfunction.We had already performed MR-guided microwave ablation therapy to hepatic tumors located in every segment of the liver. However, percutaneous puncture of the tumors in the subphrenic area was not easy with the abdominal approach. In these cases, a combination of thoracoscopic and MR-guidance has been beneficial. MR compatible endoscope made us easily to puncture hepatic tumors located in every segment of the liver. MR-guided microwave ablation therapy is a feasible treatment for hepatic tumors.