Objective: The objective of this study was to evaluate the treatment efficacy and overall survival (OS) of percutaneous ultrasound-guided thermal ablation by means of microwave ablation or radiofrequency ablation for intrahepatic cholangiocarcinoma (ICC). Methods: 18 patients with 25 ICC nodules underwent ultrasound-guided thermal ablation with curative intention. 8 patients were primary cases and 10 were recurrent cases after curative resection. The local treatment response, complications and survivals were analysed. Results: Complete ablation was achieved in 23 (92.0%, 23/25) nodules (diameter, 0.7-4.3 cm; mean, 2.5¡0.9 cm) and incomplete ablation was found in 2 (8.0%, 2/25) larger tumours (6.4 and 6.9 cm in diameter). No death associated with the treatment was found. The major complication rate was 5.5% (1/18). The follow-up periods ranged from 1.3 to 86.2 months (mean, 20.5¡26.3 months; median, 8.7 months). OS rates for all patients at 6, 12, 36 and 60 months were 66.7%, 36.3%, 30.3% and 30.3%, respectively. By univariate analysis, the patient source (primary or recurrent case) was found to be a significant prognostic factor for OS rates (p50.001). The patient source (p50.001) and the number of nodules (p50.038) were found to be significant prognostic factors for recurrence-free survival. OS rates for the primary ICC at 6, 12, 36 and 60 months were 87.5%, 75.0%, 62.5% and 62.5%, respectively. Conclusion: Percutaneous ultrasound-guided thermal ablation is a safe and effective therapeutic technique for ICC. Acceptable survival can be achieved in primary ICCs, whereas the prognosis of recurrent ICCs is relatively poor.

Objective: To investigate the correlation between enhancement patterns of intrahepatic cholangiocarcinoma (ICC) on contrast-enhanced ultrasound (CEUS) and pathological findings. Methods: The CEUS enhancement patterns of 40 pathologically proven ICC lesions were retrospectively analysed. Pathologically, the degree of tumour cell and fibrosis distribution in the lesion was semi-quantitatively evaluated. Results: 4 enhancement patterns were observed in the arterial phase for 32 massforming ICCs: peripheral rim-like hyperenhancement (n519); heterogeneous hyperenhancement (n56); homogeneous hyperenhancement (n53); and heterogeneous hypo-enhancement (n54). Among the four enhancement patterns, the differences in tumour cell distribution were statistically significant (p,0.05). The hyperenhancing area on CEUS corresponded to more tumour cells for mass-forming ICCs. Heterogeneous hyperenhancement (n52) and heterogeneous hypo-enhancement (n52) were observed in the arterial phase for four periductal infiltrating ICCs. In this subtype, fibrosis was more commonly found in the lesions. Heterogeneous hyperenhancement (n51) and homogeneous hyperenhancement (n53) were observed in the arterial phase for four intraductal growing ICCs. This subtype tended to have abundant tumour cells. Conclusion: The CEUS findings of ICC relate to the degree of carcinoma cell proliferation at pathological examination. Hyperenhancing areas in the tumour always indicated increased density of cancer cells.

CEUS improves diagnostic performance in differentiating HCCs from non-neoplastic nodules in cirrhotic patients compared with baseline ultrasound. Diagnosis of HCCs ≤2.0 cm diameter by CEUS is still a clinical concern, and thus needs further investigation.

Background: Cassava leaf contains many kinds of flavonoids, most of flavonoids function as effective antioxidants in vivo. The protective effects of cassava (Manihot esculenta Crantz) leaf flavonoid extracts on liver damage were evaluated by carbon tetrachloride (CCl 4 )-induced injury in mice. Materials and methods: The protective effects of cassava leaf flavonoid extracts on liver damage were evaluated using CCl 4 -induced injury in mice. The mice were weighted to calculate sample quantity of mice. Bloods were taken to evaluate ALT and AST of serums. Livers were excised and weighted, and fixed for pathological observation. Prepared 10% liver tissue homogenate was used to evaluate MDA, SOD, GSH-PX levels. Results: Cassava leaf flavonoid extracts significantly decreased (p < 0.05) the relative liver weight when compared with the CCl 4 -treated group. The contents of ALT and AST in serum of experiment mice declined significantly when compared to those of the CCl 4 -treated group, but did not reach normal levels of control group. Pathological observation of livers showed that cassava leaf flavonoid extracts significantly ameliorated the CCl 4 -induced pathological changes. Conclusion These results provided biological evidence that cassava leaf flavonoid extracts indeed expressed potential efficacy of prohibiting liver injury in mice.