Comparison of peri-diaphragmatic hydrodissection versus artificial ascites/pleural effusion in assisting percutaneous ultrasound-guided microwave ablation of right subphrenic colorectal liver metastasis
10.3760/cma.j.cn131148-20250610-00311
- VernacularTitle:水隔离带与人工胸腹水辅助超声引导右膈下结直肠癌肝转移瘤微波消融对比
- Author:
Si QIN
1
;
Jingwen ZHOU
1
;
Hai HUANG
1
;
Guangjian LIU
1
Author Information
1. 中山大学附属第六医院超声科 广州市黄埔区中六生物医学创新研究院，广州 510655
- Publication Type:Journal Article
- Keywords:
Contrast-enhanced ultrasound;
Hydrodissection;
Liver metastasis;
Microwave ablation
- From:
Chinese Journal of Ultrasonography
2025;34(11):992-998
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the efficacy and safety of peri-diaphragmatic hydrodissection in assisting microwave ablation（MWA）of right subphrenic colorectal liver metastasis（CRLM）.Methods:A retrospective analysis was conducted on 101 patients with right subphrenic CRLMs（206 lesions）who underwent percutaneous ultrasound-guided MWA at the Sixth Affiliated Hospital，Sun Yat-sen University from June 2020 to June 2023. Patients were divided into contrast-enhanced ultrasound（CEUS）with hydrodissection group（ n=63）and artificial ascites/pleural effusion group（ n=38，there were 17 patients with artificial pleural effusion，21 patients with artificial ascites）. In the CEUS with hydrodissection group，the peri-diaphragmatic water dissection was established during the post-vascular phase of CEUS. Lesion detection rates，visualization scores，local tumor progression（LTP），and complications were compared between the two groups. Results:In both the CEUS with hydrodissection group and the artificial ascites/pleural effusion group，the lesion detection rates（96.9% and 98.7%）and visualization scores［（3.7 ± 1.3）points and（4.6 ± 0.7）points］improved with water dissection assistance compared to conventional ultrasound［detection rates of 57.5% and 55.7%，visualization scores of（1.9 ± 1.0）points and（2.6 ± 1.5）points］and CEUS alone［detection rates of 78.0% and 78.5%，visualization scores of（3.1 ± 1.5）points and（3.7 ± 1.6）points］（all P<0.001）. The CEUS with hydrodissection group achieved comparable success rates（96.8% vs. 97.4%， P>0.99）but required less saline［60（30，90）ml vs. 500（500，1 000）ml， P<0.001］than artificial ascites/pleural effusion group. No significant differences were observed in LTP rates，complications，or pain scores（all P>0.05）. Conclusions:CEUS combined with peri-diaphragmatic hydrodissection improves detection rates and visualization of right subphrenic CRLM while reducing fluid volume compared to artificial hydrothorax/ascites，serving as a safe and effective adjunct for percutaneous MWA.
