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DOI: 10.1148/radiol.2433060157
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Percutaneous Radiofrequency Ablation of Hepatic Tumors against the Diaphragm: Frequency of Diaphragmatic Injury1

Hayden W. Head, MD, Gerald D. Dodd, III, MD, Neal C. Dalrymple, MD, Srinivas R. Prasad, MD, Fadi M. El-Merhi, MD, Michael W. Freckleton, MD, and Linda G. Hubbard, RN

1 From the Department of Radiology, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr, Mail Code 7800, San Antonio, TX 78229. From the 2003 RSNA Annual Meeting. Received January 26, 2006; revision requested March 27; revision received June 29; accepted August 2; final version accepted October 4. Address correspondence to H.W.H. (e-mail: headh{at}uthscsa.edu).


Figure 1A
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  		Figure 1a: Transverse CT scans in 58-year-old man treated with RF ablation for nodular HCC in Couinaud segment VII abutting dome of the diaphragm. (a) Before ablation, arterial enhancing tumor (arrowhead) is seen. (b) After ablation, tumor with hyperemic rim and no adjacent diaphragmatic thickening is seen.

 

Figure 1B
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  		Figure 1b: Transverse CT scans in 58-year-old man treated with RF ablation for nodular HCC in Couinaud segment VII abutting dome of the diaphragm. (a) Before ablation, arterial enhancing tumor (arrowhead) is seen. (b) After ablation, tumor with hyperemic rim and no adjacent diaphragmatic thickening is seen.

 

Figure 2A
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  		Figure 2a: RF ablation of tumor against diaphragm with subsequent smooth diaphragmatic thickening. (a) Transverse CT scan obtained before reablation for locally progressive metastatic tumor. (b) Transverse CT scan obtained immediately after ablation shows smooth diaphragmatic thickening adjacent to the ablation zone (arrowhead).

 

Figure 2B
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  		Figure 2b: RF ablation of tumor against diaphragm with subsequent smooth diaphragmatic thickening. (a) Transverse CT scan obtained before reablation for locally progressive metastatic tumor. (b) Transverse CT scan obtained immediately after ablation shows smooth diaphragmatic thickening adjacent to the ablation zone (arrowhead).

 

Figure 3A
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  		Figure 3a: Transverse CT scans in 52-year-old man after RF ablation for metastasis to liver abutting the diaphragm. (a) At 1 day after ablation, adjacent diaphragmatic thickening is seen. (b) At 1 month after ablation, focal nodular diaphragmatic thickening (arrowhead) is seen. (c) At 11 months after ablation, minimal remaining diaphragmatic thickening can be seen.

 

Figure 3B
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  		Figure 3b: Transverse CT scans in 52-year-old man after RF ablation for metastasis to liver abutting the diaphragm. (a) At 1 day after ablation, adjacent diaphragmatic thickening is seen. (b) At 1 month after ablation, focal nodular diaphragmatic thickening (arrowhead) is seen. (c) At 11 months after ablation, minimal remaining diaphragmatic thickening can be seen.

 

Figure 3C
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  		Figure 3c: Transverse CT scans in 52-year-old man after RF ablation for metastasis to liver abutting the diaphragm. (a) At 1 day after ablation, adjacent diaphragmatic thickening is seen. (b) At 1 month after ablation, focal nodular diaphragmatic thickening (arrowhead) is seen. (c) At 11 months after ablation, minimal remaining diaphragmatic thickening can be seen.

 




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