Brieger Jens, Pereira Philippe L, Trübenbach Jochen, Schenk Martin, Kröber Stefan-Martin, Schmidt Diethard, Aubé Christophe, Claussen Claus D, Schick Fritz
Section of Experimental Radiology, University Hospital of Tübingen, Germany.
Invest Radiol. 2003 Oct;38(10):609-16. doi: 10.1097/01.rli.0000077122.70885.94.
To evaluate the efficiency of 4 radiofrequency (RF) systems by assessing the amount of delivered energy for each thermal induced lesion after perfusion mediated RF ablation and to compare the influence of perfusion mediation types on the energy efficiency.
A total of 43 ablations in 16 male landrace pigs with 4 RF devices were performed strictly according to the manufacturers' instructions. Total absorbed energy was computed and then related to 3D volumetry obtained after histopathological evaluation. Sixteen ablations were performed under physiological liver perfusion and 27 ablations with occlusion of portal vein, hepatic artery, or both vessels. Energy efficiency values of the RF systems for different vascular occlusion techniques were compared and analyzed by a nonparametrical rank sum test.
Under physiological perfusion, the average energy delivered to produce 1-cm3 lesion size was calculated to 1650 +/- 929, 3097 +/- 389, 8312 +/- 2068, and 5493 +/- 2306 Watt x s/cm3 for the Berchtold, Radionics, Radiotherapeutics, and RITA system, respectively. After perfusion-mediated RF ablation, artery occlusion was not as effective as portal vein occlusion, which reduced the energy to 587 +/- 148, 869 +/- 276, and 903 +/- 394 Watt. s/cm3 for the Berchtold, Radionics, and Radiotherapeutics system, respectively. The occlusion of vessels, portal vein, and artery or portal vein alone increased the energy efficiency compared with physiological liver perfusion or occlusion of the artery (P = 0,003).
Under physiological liver perfusion the open perfused system and the internally cooled system provided the best efficiency values with lowest standard deviations. The energy efficiency was increased markedly for all systems after occlusion of the portal vein either alone or in combination with arterial occlusion. Occlusion of the hepatic artery did not improve the efficiency.
通过评估灌注介导射频消融后每个热诱导损伤所传递的能量，来评估4种射频（RF）系统的效率，并比较灌注介导类型对能量效率的影响。
对16头雄性长白猪使用4种射频设备进行了总共43次消融，严格按照制造商的说明进行操作。计算总吸收能量，然后将其与组织病理学评估后获得的三维容积进行关联。16次消融在生理性肝灌注下进行，27次消融采用门静脉、肝动脉或两者血管闭塞。通过非参数秩和检验比较并分析不同血管闭塞技术下射频系统的能量效率值。
在生理性灌注下，对于Berchtold、Radionics、Radiotherapeutics和RITA系统，产生1立方厘米损伤大小所输送的平均能量分别计算为1650±929、3097±389、8312±2068和5493±2306瓦·秒/立方厘米。灌注介导射频消融后，动脉闭塞不如门静脉闭塞有效，门静脉闭塞后，Berchtold、Radionics和Radiotherapeutics系统的能量分别降至587±148、869±276和903±394瓦·秒/立方厘米。与生理性肝灌注或动脉闭塞相比，血管、门静脉和动脉或仅门静脉的闭塞提高了能量效率（P = 0.003）。
在生理性肝灌注下，开放灌注系统和内部冷却系统提供了最佳效率值，标准差最低。单独或与动脉闭塞联合闭塞门静脉后，所有系统的能量效率均显著提高。肝动脉闭塞并未提高效率。
