Fig. 3

A patient with a history of hepatectomy and cholecystectomy. The index tumor was in segment 6 and was ablated with RFA. CEUS (a) and MR (c) show that the distance between the index tumor (white arrow) and intestine (red arrow) was < 5 mm. b A PTC needle was inserted with the tip visible (red arrow) in the gap between the tumor (white arrow) and the intestine. However, after perfusion with ascites, B-mode ultrasound showed that the gap could not be opened because of intraperitoneal adhesions (red outline). d Yellow arrow showed the tract of PTC needle. Intracavitary CEUS was injected through the PTC needle and showed ascites surrounding the index tumor and the intestinal tract. The ascites can flow continually between the lesion and the intestine (red outline), and continuing injection of normal saline removed the thermal energy induced by ablation. After ablation, CEUS (e) and CEMR (f) showed that the tumor was completely ablated