PMC6445535_01
US examination shown in (A): The 14-mm pathologic nodule (arrow) near the scar in the soleus muscle and (B): The 8-mm pathologic nodule (arrow) near the scar of the lateral calf of the gastrocnemius.
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figure1
Both nodules were also visible at ultrasound (US) examination (Figure 1A and B).
Laser ablation. (A): Injection of local anaesthesia through a small needle (arrow) at the level of the more dorsal lesion (star). (B): A bare-tip, 300 mum in diameter laser fibre, is introduced through a small needle (arrow) into the lesion to be treated (star). (C): The arrows show the gas bubbles produced by the procedure. After another injection of local anaesthesia and hydro-dissection, the medial lesion was treated inserting two parallel 21-gauge Chiba needles and laser fibres. Thermal ablation was performed with one pull-back and a total energy of 3,200 Joule.
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Local anaesthesia with Mepivacain diluted in physiological solution was injected at the level of the more dorsal lesion, also achieving a separation of the lesion from the skin (Figure 2A). Ablation with one pull-back and a total amount of energy of 2,400 Joules was performed at a fixed power of 3 W (Figure 2A and C).
Post-treatment CEUS showing large avascular area, including the 14-mm treated nodule (arrows).
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In fact, there was no evidence of residual hyper-enhancing foci, suggesting complete necrosis of both nodules (Figures 3 and 4).
Post-treatment CEUS showing large avascular area, including the 8-mm treated nodule (arrows).
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In fact, there was no evidence of residual hyper-enhancing foci, suggesting complete necrosis of both nodules (Figures 3 and 4).
Two months after PLA, the 14-mm nodule appeared smaller (8 x 4 mm) than before the treatment (arrow).
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