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Fig. 1 | BMC Cancer

Fig. 1

From: The value of 3D visualization operative planning system in ultrasound-guided percutaneous microwave ablation for large hepatic hemangiomas: a clinical comparative study

Fig. 1

Images of a 28-year-old woman who underwent US-PMWA for larger hepatic cavernous hemangioma (LHH) (10.4 cmx6.9 cmx8.4 cm) assisted by a 3D visualization operative planning system. a Preoperative contrast-enhanced MRI showed the LHH with peripheral nodular hyperenhancement in the artery phase in the right lobe accompanied by two feeding arteries (white arrows). b-c Preoperative contrast-enhanced ultrasound imaging also showed the LHH with peripheral nodular hyperenhancement in the artery phase in the right lobe (white arrow) companying with two feeding arteries (yellow arrow). d-f 3D visualization operative planning system showed the location and relationship with the tumor and the surrounding organs and the feed arteries stereoscopically (yellow arrow), quantized the volume of the liver and LHH (liver: 1396.94 ml; LHH:197 ml), projected the number and the pathway of the ablation antenna implantation, the ablation time and energy, simulated the thermal field, and provided the location of the aspiration blood needle, which is at the center of the LHH. g-i The ablation procedure was performed according to the panning. First, the arteries were ablated by higher power (g) and blood was aspirated from the sinus (h). Two antennas were subsequently implanted in the LHH according to planning with two insertion and eight ablation points (i) (yellow arrow). j-l After ablation, the CEUS image immediately after ablation showed no enhancement in the ablation zone with a shrunk size (j). In the MRI image 3 days after ablation, the tumor residual nuclear and ablation zones were clearly demonstrated, and the residual nuclear zone had largely shrunk (k). The post-operative 3D visualization system safely showed the tumor residual nuclear and ablation zones and the surrounding organs; the volumes of the tumor residual nuclear and ablation zones and the reduction rate of the volume were also calculated (58.6 ml, 131.0 ml and 70.3%) (l) (yellow and white arrows)

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