High-intensity focused ultrasound for treatment of portal vein tumor thrombosis:40 cases report

AIM:To evaluate the efficacy and clinical value of high-intensity focused ultrasound(HIFU) for the treatment of portal vein tumor thrombus(PVTT) in patients with hepatocellular carcinoma. METHODS:Forty patients with advanced hepatocellular carcinoma including 51 PVTT portal veins and main branches,were treated with HIFU,and the changes in the blood flow of PVTT embolized portal vein,the echo and the size of tumor thrombi,the function of liver,the ascites and the life quality were observed. RESULTS:Before treatment,there was no blood flow signal,with low echo and equivalent echo on color Duppler ultrasonography in 15 PVTT embolized portal veins of 11 patients. After 3 or 4 times treatment,the low echo and equivalent echo became moderate or strong echo; the volume of PVTT were reduced by 1/2-1/3,and color flow signals were seen in 13 portal vein. After 5-7 times treatment,the echo of blood flow in 15 portal veins was significantly enhanced and the volume of PVTT was reduced,and the signal of blood flow in 13 portal veins became continuous and stable signal indicating repatency. The improvements of liver function,ascites and life quality to varying degrees were observed. After treatment,the echo of blood flow in 36 portal veins of 29 patients was significantly enhanced and the volume of PVTT was reduced by 1/2-1/5,and the signal of blood flow changed from unstable to stable,indicating repatency. CONCLUSION:HIFU may be a safe,less painful,noninvasive and effective new method in the treatment of patients with PVTT.