Denys A L, De Baere T, Mahe C, Sabourin J C, Sa Cunha A, Germain S, Roche A
Department of Interventional Radiology, Centre Hospitalo Universitaire Vaudois, 1011 Lausanne, Switzerland.
Eur Radiol. 2001;11(10):2102-8. doi: 10.1007/s003300100973.
The aim of this study was to assess the effect of vascular occlusion on radio-frequency (RF) lesion size and on potential associated biliary and portal lesions. Radio-frequency lesions using a 1-cm exposed-tip cooled electrode were created in pig liver. Liver perfusion was modified by arterial embolization (n=2), left portal clamping (n=2), and both (n=2). Two pigs were used as controls. Two weeks after, control portography was performed, animals were killed, and ex-vivo cholangiography was carried out. Pathological studies evaluated the lesion surface and associated portal and biliary damages. A mathematical regression model showed that portal occlusion increased by 43 mm2 (+40%) the surface of RF lesions, arterial occlusion by 135 mm2 (+126%), and associated occlusion by 466 mm2 (+435%). Biliary stenoses were found in 4 cases (two arterial occlusions, one portal occlusion, and one associated occlusion). One case of partial portal vein thrombosis was found in one case of portal occlusion and resolved at 2 weeks. Ischemic damages adjacent to RF lesions were found in cases of combined occlusions. The reduction of liver perfusion increases significantly the size of RF lesions but is associated with a risk of biliary, portal, or parenchymal complications.
本研究的目的是评估血管闭塞对射频（RF）病灶大小以及潜在相关胆管和门静脉病灶的影响。使用1厘米外露尖端冷却电极在猪肝中制造射频病灶。通过动脉栓塞（n = 2）、左门静脉夹闭（n = 2）以及两者联合（n = 2）来改变肝脏灌注。两只猪用作对照。两周后，进行对照门静脉造影，处死动物，并进行离体胆管造影。病理研究评估病灶表面以及相关的门静脉和胆管损伤。一个数学回归模型显示，门静脉闭塞使RF病灶表面增加43平方毫米（+40%），动脉闭塞使其增加135平方毫米（+126%），联合闭塞使其增加466平方毫米（+435%）。在4例中发现胆管狭窄（2例动脉闭塞、1例门静脉闭塞和1例联合闭塞）。在1例门静脉闭塞中发现1例部分门静脉血栓形成，2周时消退。在联合闭塞的病例中发现RF病灶附近有缺血性损伤。肝脏灌注的减少显著增加了RF病灶的大小，但伴有胆管、门静脉或实质并发症的风险。
