兔肝脏联合射频消融与热盐水注射

Combined radiofrequency ablation and hot saline injection in rabbit liver.

作者信息

Kim Young Kon, Lee Jeong Min, Kim Sang Won, Kim Chong Soo

机构信息

Department of Radiology, Chonbuk National University Medical School, Chonju, Seoul, Korea.

出版信息

Invest Radiol. 2003 Nov;38(11):725-32. doi: 10.1097/01.rli.0000084360.10254.41.

DOI:10.1097/01.rli.0000084360.10254.41

PMID:14566183

Abstract

RATIONALE AND OBJECTIVES

To determine whether combining hot saline injection (HSI) and radiofrequency ablation (RFA) can increase the extent of thermally mediated coagulation in in vivo rabbit liver tissue.

METHODS

In 66 rabbits, RF energy and/or hot saline-induced coagulations were produced using a 17-gauge cooled electrode or 21-gauge needle under ultrasound guidance. Rabbits were allocated into 1 of 5 groups: group A, RFA alone (n = 15); group B, HSI (1 mL hot saline infused, n = 10); group C, combined therapy for HSI followed by RFA (n = 21); group D, combined therapy for RFA immediately followed by HSI (n = 10); and group E, 1 mL room temperature saline infusion before RFA (n = 10). RF energy (30 W) was applied for 3 minutes. The changes in tissue impedance, current, power output, and temperature of the electrode tip were automatically measured. Before RFA, precontrast computed tomography was performed, and after RFA, pre- and postcontrast spiral computed tomographic scans were acquired. The maximum diameters of the thermal lesions on the gross specimens and complications of each group were compared.

RESULTS

All procedures were technically successful. There were 9 of 61 procedure-related complications (14.8%) including 6 localized hematomas and 3 thermal injuries to the diaphragm and the stomach. In rabbits in groups C and E, a marked decrease of tissue impedance (43.4 omega, 44.1 omega) and an increase of current (709 mA, 722 mA) occurred with instillation of saline infusion compared with RFA only. Combined therapy for HSI followed by RFA produced a greater short-axis mean diameter of coagulation (14.6 +/- 4.3 mm) than that in rabbits of other groups, for RFA only (10.4 +/- 2.4 mm), HSI only (8.7 +/- 3.3 mm), and combined therapy for RFA immediately followed by HIS (12.0 +/- 1.4 mm; P < 0.05).

CONCLUSION

Combined therapy for HSI followed by RFA can increase the volume of RFA-induced coagulation in the liver with a single application, and therefore may improve the results of RFA for the treatment of larger tumors.

摘要

原理与目的

确定热盐水注射（HSI）联合射频消融（RFA）是否能增加兔肝脏组织体内热介导凝固的范围。

方法

在66只兔子中，在超声引导下使用17号冷却电极或21号针产生射频能量和/或热盐水诱导的凝固。兔子被分为5组中的1组：A组，单纯RFA（n = 15）；B组，HSI（注入1 mL热盐水，n = 10）；C组，先HSI后RFA的联合治疗（n = 21）；D组，RFA后立即HSI的联合治疗（n = 10）；E组，RFA前注入1 mL室温盐水（n = 10）。施加30 W射频能量3分钟。自动测量组织阻抗、电流、功率输出和电极尖端温度的变化。在RFA前进行平扫计算机断层扫描，在RFA后进行平扫和增强螺旋计算机断层扫描。比较每组大体标本上热损伤灶的最大直径和并发症。

结果

所有操作在技术上均成功。61例与操作相关的并发症中有9例（14.8%），包括6例局部血肿和3例膈肌及胃的热损伤。与单纯RFA相比，C组和E组兔子在注入盐水时组织阻抗显著降低（43.4Ω，44.1Ω），电流增加（709 mA，722 mA）。先HSI后RFA的联合治疗产生的凝固短轴平均直径（14.6±4.3 mm）大于其他组兔子，单纯RFA组（10.4±2.4 mm）、单纯HSI组（8.7±3.3 mm）以及RFA后立即HSI的联合治疗组（12.0±1.4 mm；P < 0.05）。