Chinn S B, Lee F T, Kennedy G D, Chinn C, Johnson C D, Winter T C, Warner T F, Mahvi D M
Department of Radiology, E3/311 CSC, University of Wisconsin, 600 Highland Ave., Madison, WI 53792, USA.
AJR Am J Roentgenol. 2001 Mar;176(3):789-95. doi: 10.2214/ajr.176.3.1760789.
This study determined the effect of vascular occlusion on radiofrequency lesion shape, volume, and temperature in a porcine liver model.
Radiofrequency lesions (n = 33) were created in the livers of six domestic pigs in vivo using a multiprong radiofrequency electrode. Lesions were randomly assigned to one of four vascular occlusion groups: portal vein, hepatic artery, Pringle maneuver (both hepatic artery and portal vein), or no occlusion. Radiofrequency parameters were time, 7 min; power, 50 W; and target temperature, 100 degrees C. Temperatures were measured 5, 10, and 15 mm from the electrode. After the animals were sacrificed, the lesions were excised. Lesion volume, diameter, and shape; maximum temperature; and time exposed to lethal temperatures (42-60 degrees C) were determined.
Lesion volume was greatest with the Pringle maneuver lesions (12.6 +/- 4.8 cm(3)), followed by occlusion of the portal vein (8.6 +/- 3.8 cm(3)), occlusion of the hepatic artery (7.6 +/- 2.9 cm(3)), and no occlusion (4.3 +/- 1.0 cm(3)) (p < 0.05). Maximum lesion diameter was similar with the Pringle maneuver (3.3 +/- 0.3 cm), the portal vein (3.3 +/- 0.2 cm), and the hepatic artery (3.2 +/- 0.2 cm) groups compared with no occlusion (2.6 +/- 1.0 cm) (p < 0.05). Minimum lesion diameter ranged from 2.9 cm for Pringle maneuver lesions to 1.0 cm for lesions with no occlusion (p < 0.05). Vascular occlusion increased the time tissue was exposed to lethal temperatures (> 42-60 degrees C) and created more spherical lesions than no occlusion.
Vascular occlusion combined with radiofrequency ablation increases the volume of necrosis, creates a more spherical lesion, and increases the time tissue is exposed to lethal temperatures when compared with radiofrequency alone. Most of this vascular occlusion effect could be accomplished with hepatic artery occlusion alone.
本研究在猪肝脏模型中确定血管闭塞对射频消融病灶形状、体积及温度的影响。
使用多针射频电极在6头家猪肝脏内制造射频消融病灶（n = 33个）。将病灶随机分为4个血管闭塞组之一：门静脉闭塞组、肝动脉闭塞组、Pringle手法组（肝动脉和门静脉均闭塞）或无闭塞组。射频参数为时间7分钟、功率50瓦、目标温度100℃。在距电极5、10和15毫米处测量温度。动物处死后，切除病灶。测定病灶体积、直径和形状、最高温度以及暴露于致死温度（42 - 60℃）的时间。
Pringle手法组病灶体积最大（12.6±4.8立方厘米），其次是门静脉闭塞组（8.6±3.8立方厘米）、肝动脉闭塞组（7.6±2.9立方厘米）和无闭塞组（4.3±1.0立方厘米）（p < 0.05）。与无闭塞组（2.6±1.0厘米）相比，Pringle手法组（3.3±0.3厘米）、门静脉组（3.3±0.2厘米）和肝动脉组（3.2±0.2厘米）的最大病灶直径相似（p < 0.05）。最小病灶直径范围从Pringle手法组的2.9厘米到无闭塞组病灶的1.0厘米（p < 0.05）。与无闭塞相比，血管闭塞增加了组织暴露于致死温度（> 42 - 60℃）的时间，并产生了更接近球形的病灶。
与单纯射频消融相比，血管闭塞联合射频消融增加了坏死体积，产生了更接近球形的病灶，并增加了组织暴露于致死温度的时间。大部分血管闭塞效应单独通过肝动脉闭塞即可实现。
