Purpose To evaluate the safety and efficacy of microwave ablation (MWA) in patients with end-stage renal disease and secondary hyperparathyroidism. Materials and Methods The study protocol was approved by the human ethics review committee. Between March 1, 2014, and June 30, 2015, 51 patients (25 men, 26 women; mean age ± standard deviation, 53.1 years ± 12.9) were enrolled. All patients had at least one enlarged parathyroid gland and secondary symptomatic hyperparathyroidism, which was treated with ultrasonographically (US) guided MWA. The levels of intact parathyroid hormone, serum calcium, phosphorus, and alkaline phosphatase were compared before and after MWA. Paired-sample t tests and paired-sample Wilcoxon signed-rank tests were used to compare treatment outcomes before and after MWA. Results Complete ablation was achieved in all 96 glands in 51 of 120 patients with severe secondary hyperparathyroidism. The mean follow-up time was 11.1 months ± 3.3. The maximum diameter of the glands ranged from 0.5 cm to 4.8 cm (mean, 1.5 cm ± 0.6). The ablation time for each gland was 216.1 seconds ± 130.1. The mean serum intact parathyroid hormone, calcium, and phosphorus levels after MWA (400 pg/mL [400 ng/L; range, 151.3-629.0 ng/L], 2.33 mmol/L ± 0.23, and 1.54 mmol/L ± 0.43, respectively) were significantly lower than those before MWA (1203 pg/mL [1203 ng/L; range, 854.7-1694.5 ng/L], 2.53 mmol/L ± 0.24, and 1.97 mmol/L ± 0.50, respectively; P < .01), while the alkaline phosphatase levels did not change with MWA (P > .05). Ipsilateral recurrent laryngeal nerve injury was seen in one patient (2%). A hematoma developed during one procedure in one patient (2%) and was treated successfully with injection of thrombin. Conclusion US-guided MWA is safe and effective for destroying parathyroid gland tissue in patients with end-stage renal disease and severe secondary hyperparathyroidism. Further experience with the technique is clearly necessary. RSNA, 2016.

There are different ultrasonographic predictors for the evaluation of hepatic inflammation grade and fibrosis stage of chronic hepatitis. Both ultrasonography and serology have their own advantages and disadvantages in the evaluation of liver fibrosis and compensated liver cirrhosis. Combined application of the two methods is hopeful to improve the diagnostic accuracy.

Bile duct injury after ablation of MLTs was the result of local treatment-related factors combined with the patients' general condition. The minimum safe distance for ablation of tumor abutting a bile duct was 10 mm.

Background To compare the rate of bleeding for ultrasound-guided Percutaneous Transhepatic Biliary Drainage (PTBD) in patients with coagulopathy to that in patients with normal coagulation. Methods This retrospective study included a total of 837 patients who underwent PTBDs from January 2016 to December 2017. The latest coagulation parameters before PTBD were acquired in all patients. The incidence of PTBD-related bleeding was determined, and the association between bleeding and coagulopathy was evaluated. Coagulopathy referred to elevated INR (International Normalized Ratio, > 1.5) or thrombocytopenia (Platelet or PLT < 50×109/L). In this study, highest value of INR was 3.67 and lowest value of PLT was 31×109/L. Results Overall, 32of 837 patients (3.8%) experienced bleeding, 28 (3.3%) for mild bleeding and 4 (0.5%) for severe bleeding. Incidence of bleeding in patients with abnormal PLT and INR values wasn’t significantly different from those in patients with normal PLT (p = 0.769) and INR (p = 0.511). No bleeding was detected in patients with thrombocytopenia. Three cases of mild bleeding were observed in patients with INR > 1.5 (n = 60), no severe bleeding was detected. Impaired coagulopathy function was not found in patients with severe bleeding. Age (p = 0.152), gender (p = 0.094) and underlying diseases (p = 0.318) didn’t correlate significantly with the incidence or severity of PTBD-related bleeding. Conclusions In our study, patients with thrombocytopenia (30×109/L < PLT < 50×109/L) or increased INR (> 1.5) didn’t suffer from higher incidence of or more severe bleeding after PTBD.

No abstract