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Assessment of Cerebral Microembolism During Percutaneous Radiofrequency Ablation of Lung Tumors Using Diffusion-Weighted Imaging

Akira Yamamoto1, Toshiyuki Matsuoka1, Masami Toyoshima1, Tomohisa Okuma1, Yoshimasa Oyama1, Masao Hamuro1, Keiko Nakayama1, Kiyotoshi Inoue2, Kenji Nakamura1 and Yuichi Inoue1

1 Department of Radiology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan.
2 Second Department of Surgery, Osaka City University Graduate School of Medicine, Abeno-ku, Osaka 545-8585, Japan.



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Fig. 1A. 65-year-old man with 25-mm lung metastasis from leiomyosarcoma (patient 7 in Table 1). Sonogram in carotid artery during pulmonary radiofrequency ablation shows microemboli and materials (white arrow) that are considered to be microbubbles. Visible vertical spike (black arrows) indicating passage of emboli is observed.

 


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Fig. 1B. 65-year-old man with 25-mm lung metastasis from leiomyosarcoma (patient 7 in Table 1). Diffusion-weighted image (B) and FLAIR image (C) of head obtained 20 hr after radiofrequency ablation show no new area of abnormal intensity and no evidence of acute stroke. High-intensity area in bilateral posterior periventricular white matter was present on preoperative MR image (not shown).

 


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Fig. 1C. 65-year-old man with 25-mm lung metastasis from leiomyosarcoma (patient 7 in Table 1). Diffusion-weighted image (B) and FLAIR image (C) of head obtained 20 hr after radiofrequency ablation show no new area of abnormal intensity and no evidence of acute stroke. High-intensity area in bilateral posterior periventricular white matter was present on preoperative MR image (not shown).

 


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Fig. 2A. Graphs illustrate findings. Graphs show relation between existence of microemboli (white bars) and tumor size (A), maximum power (B), and treatment time (C). Black bars indicate number of patients with no microemboli. Analyses show difference between patients with microemboli and those with no microemboli is statistically significant for average tumor size (p = 0.0100), average maximum power (p = 0.0149), and average treatment time (p = 0.0183).

 


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Fig. 2B. Graphs illustrate findings. Graphs show relation between existence of microemboli (white bars) and tumor size (A), maximum power (B), and treatment time (C). Black bars indicate number of patients with no microemboli. Analyses show difference between patients with microemboli and those with no microemboli is statistically significant for average tumor size (p = 0.0100), average maximum power (p = 0.0149), and average treatment time (p = 0.0183).

 


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Fig. 2C. Graphs illustrate findings. Graphs show relation between existence of microemboli (white bars) and tumor size (A), maximum power (B), and treatment time (C). Black bars indicate number of patients with no microemboli. Analyses show difference between patients with microemboli and those with no microemboli is statistically significant for average tumor size (p = 0.0100), average maximum power (p = 0.0149), and average treatment time (p = 0.0183).

 

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