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Changes in Bile Ducts after Radiofrequency Ablation of Hepatocellular Carcinoma: Frequency and Clinical Significance

¹ All authors: Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-dong, Kangnam-ku, Seoul 135-710, South Korea.

View larger version (150K): [in a new window]   Fig. 1A. —49-year-old man with hepatocellular carcinoma who had asymptomatic bile duct change after radiofrequency ablation. Contrast-enhanced CT scan obtained during arterial phase before radiofrequency ablation shows 3-cm-diameter hepatocellular carcinoma (arrows) in right hepatic lobe.

View larger version (135K): [in a new window]   Fig. 1B. —49-year-old man with hepatocellular carcinoma who had asymptomatic bile duct change after radiofrequency ablation. Contrast-enhanced CT scan obtained 4 months after radiofrequency ablation shows mild dilatation of upstream bile duct (arrowheads) in liver posterior to ablation zone (arrows).

View larger version (132K): [in a new window]   Fig. 1C. —49-year-old man with hepatocellular carcinoma who had asymptomatic bile duct change after radiofrequency ablation. Contrast-enhanced CT scan obtained 31 months after radiofrequency ablation shows slight progression of bile duct dilatation (arrowheads) with no symptoms, in contrast to decrease in size of ablation zone (arrows).

View larger version (120K): [in a new window]   Fig. 2A. —55-year-old man with hepatocellular carcinoma who had biloma and upstream bile duct dilatation with cholangitis of unknown cause after radiofrequency ablation. Contrast-enhanced CT scan obtained 24 days after radiofrequency ablation for 1.4-cm-diameter hepatocellular carcinoma of liver segment VIII shows biloma (large arrows) seen as fluid collection surrounding necrotic tissue (asterisk). Associated is mild dilatation of upstream bile ducts (small arrows) in liver peripheral to ablation zone.

View larger version (138K): [in a new window]   Fig. 2B. —55-year-old man with hepatocellular carcinoma who had biloma and upstream bile duct dilatation with cholangitis of unknown cause after radiofrequency ablation. Contrast-enhanced CT scan obtained 28 days after radiofrequency ablation shows increase in size of biloma (arrows) surrounding necrotic tissue (asterisk).

View larger version (137K): [in a new window]   Fig. 2C. —55-year-old man with hepatocellular carcinoma who had biloma and upstream bile duct dilatation with cholangitis of unknown cause after radiofrequency ablation. Endoscopic retrograde cholangiogram obtained on same day as B shows leakage (arrows) of contrast medium through injured bile duct into biloma.

View larger version (105K): [in a new window]   Fig. 3A. —72-year-old woman with hepatocellular carcinoma who showed serial change in biloma on follow-up CT after radiofrequency ablation. Contrast-enhanced CT scan obtained during portal phase before radiofrequency ablation shows 4.5-cm-diameter hepatocellular carcinoma (arrows) in right lobe.

View larger version (124K): [in a new window]   Fig. 3B. —72-year-old woman with hepatocellular carcinoma who showed serial change in biloma on follow-up CT after radiofrequency ablation. Contrast-enhanced CT scan obtained 1 month after radiofrequency ablation shows round ablation zone of low attenuation (arrows). Notice fluid collection (arrowheads), representing biloma, in medial aspect of necrotic tissue (asterisk).

View larger version (102K): [in a new window]   Fig. 3C. —72-year-old woman with hepatocellular carcinoma who showed serial change in biloma on follow-up CT after radiofrequency ablation. Contrast-enhanced CT scan obtained 11 months after radiofrequency ablation shows substantial involution of biloma (arrowheads) and necrotic tissue (asterisk).

View larger version (96K): [in a new window]   Fig. 3D. —72-year-old woman with hepatocellular carcinoma who showed serial change in biloma on follow-up CT after radiofrequency ablation. Contrast-enhanced CT scan obtained 44 months after radiofrequency ablation shows greater decrease in size of biloma (arrowheads) and necrotic tissue (asterisk) than that shown in C.

View larger version (137K): [in a new window]   Fig. 4A. —64-year-old man with hepatocellular carcinoma who showed delayed appearance of bile duct dilatation after radiofrequency ablation. Contrast-enhanced CT scan obtained during arterial phase before radiofrequency ablation shows 2-cm-diameter hepatocellular carcinoma (arrows) in liver segment III.

View larger version (146K): [in a new window]   Fig. 4B. —64-year-old man with hepatocellular carcinoma who showed delayed appearance of bile duct dilatation after radiofrequency ablation. Contrast-enhanced CT scan obtained 6 months after radiofrequency ablation shows no evidence of bile duct dilatation in liver surrounding ablation zone (arrows).

View larger version (145K): [in a new window]   Fig. 4C. —64-year-old man with hepatocellular carcinoma who showed delayed appearance of bile duct dilatation after radiofrequency ablation. Contrast-enhanced CT scan obtained 9 months after radiofrequency ablation shows mild dilatation of upstream bile duct (arrows) in liver peripheral to ablation zone (asterisk).

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