Background and Aims The aim of this study was to detect the most important risk factors for recurrence after microwave ablation (MWA) of hepatocellular carcinoma (HCC). Methods A total of 92 patients with 110 HCC focal lesions (FLs) underwent MWA therapy. All the patients underwent triphasic CT before and after 1 and 3 months of MWA therapy. Complete ablation and recurrence rates were recorded, and the risk factors associated with recurrence were analyzed. Results Regarding the 110 HCC FLs that were detected pre-MWA, adequate ablation was recorded post-MWA procedure in 88 FLs (80%) and incomplete ablation in 22 FLs (showed residual contrast enhancement). However, there were newly detected lesions (17 FLs). The rate of recurrence was significantly higher in patients with multiple larger (> 4 cm) sized and hypervascular nodules. Diabetics were significantly associated with a higher recurrence rate of HCC. The rate of recurrence was significantly higher in patients with baseline level of serum alfa-fetoprotein (AFP) ≥200 ng/mL. Stiffer liver> 25 kPa had higher incidence for recurrence after ablation. Conclusion Meticulous follow-up is mandatory in diabetic patients, patients with AFP > 200 ng/dL starting value, hypervascular large hepatic FL, and in stiffer liver> 25 kPa, as these patients have higher incidence for recurrence after ablation.

Abstract:In the clinical practice, there is many overlap in diagnostic criteria between benign and malignant lymph nodes by grayscale and Doppler sonography. This study was carried out on 30 patients who suffered from enlarged cervical lymph nodes examined with B-mode US, Doppler US and Sonoelastography in the Sonoelastography unit of the Radiology department of Tanta university hospitals to prospectively estimate the accuracy of sonoelastography in the differentiation between benign and malignant cervical lymph nodes. Sonoelastography had the highest sensitivity (92.1%), specificity (95.5%) and accuracy (93.3%) in the differentiation between benign and malignant cervical lymph nodes, so Sonoelastography is a promising technique that is easy and rapid non-invasive to perform and help identifying cervical lesions that are likely to be malignant to avoid hazards that found in tissue biopsy especially in patients with bleeding disorders.