Pritchard William F, Wray-Cahen Diane, Karanian John W, Hilbert Stephen, Wood Bradford J
Center for Devices and Radiological Health, Office of Science and Technology, United States Food and Drug Administration, Rockville, MD 20852, USA.
J Vasc Interv Radiol. 2004 Feb;15(2 Pt 1):183-7. doi: 10.1097/01.rvi.000019398.74740.69.
The principal risks of needle biopsy are hemorrhage and implantation of tumor cells in the needle tract. This study compared hemorrhage after liver and kidney biopsy with and without radiofrequency (RF) ablation of the needle tract.
Biopsies of liver and kidney were performed in swine through introducer needles modified to allow RF ablation with the distal 2 cm of the needle. After each biopsy, randomization determined whether the site was to undergo RF ablation during withdrawal of the introducer needle. Temperature was measured with a thermistor stylet near the needle tip, with a target temperature of 70 degrees C-100 degrees C with RF ablation. Blood loss was measured as grams of blood absorbed in gauze at the puncture site for 2 minutes after needle withdrawal. Selected specimens were cut for gross examination.
RF ablation reduced bleeding compared with absence of RF ablation in liver and kidney (P <.01), with mean blood loss reduced 63% and 97%, respectively. Mean amounts of blood loss (+/-SD) in the liver in the RF and no-RF groups were 2.03 g +/- 4.03 (CI, 0.53-3.54 g) and 5.50 g +/- 5.58 (CI, 3.33-7.66 g), respectively. Mean amounts of blood loss in the kidney in the RF and no-RF groups were 0.26 g +/- 0.32 (CI, -0.01 to 0.53 g) and 8.79 g +/- 7.72 (CI, 2.34-15.24 g), respectively. With RF ablation, thermal coagulation of the tissue surrounding the needle tract was observed.
RF ablation of needle biopsy tracts reduced hemorrhage after biopsy in the liver and kidney and may reduce complications of hemorrhage as well as implantation of tumor cells in the tract.
针吸活检的主要风险是出血以及肿瘤细胞在针道内种植。本研究比较了肝和肾活检后针道有无射频(RF)消融时的出血情况。
通过对引导针进行改良,使其能对针的远端2 cm进行射频消融,在猪身上进行肝和肾活检。每次活检后,通过随机分组确定在拔出引导针时针道是否进行射频消融。用靠近针尖的热敏探针测量温度,射频消融时目标温度为70℃至100℃。拔针后2分钟,测量穿刺部位纱布吸收的血液量以计算失血量。选取标本进行大体检查。
与未进行射频消融相比,肝和肾活检时进行射频消融可减少出血(P <.01),平均失血量分别减少63%和97%。射频组和非射频组肝脏的平均失血量(±标准差)分别为2.03 g ± 4.03(置信区间,0.53 - 3.54 g)和5.50 g ± 5.58(置信区间,3.33 - 7.66 g)。射频组和非射频组肾脏的平均失血量分别为0.26 g ± 0.32(置信区间,-0.01至0.53 g)和8.79 g ± 7.72(置信区间,2.34 - 15.24 g)。进行射频消融时,观察到针道周围组织发生热凝固。
对针吸活检针道进行射频消融可减少肝和肾活检后的出血,并可能减少出血并发症以及肿瘤细胞在针道内的种植。