Onishi Hiromitsu, Matsushita Masaki, Murakami Takamichi, Tono Takeshi, Okamoto Shigeru, Aoki Yoshiko, Iannaccone Riccardo, Hori Masatoshi, Kim Tonsok, Osuga Keigo, Tomoda Kaname, Passariello Roberto, Nakamura Hironobu
Department of Radiology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka 565-0871, Japan.
Acad Radiol. 2004 Oct;11(10):1180-9. doi: 10.1016/j.acra.2004.06.004.
The purpose of this study was to evaluate the utility of magnetic resonance (MR) imaging for indicating the extent of true tissue necrosis of the liver after radiofrequency (RF) ablation in comparison with histopathologic findings in dog models and an autopsy case.
RF ablation of the liver parenchyma was performed on three dogs under general anesthesia. MR appearances of the RF-ablated regions on T1-weighted fast-low angle shot (FLASH; repetition time/echo time [TR/TE]/flip angle: 120/3.8/70),T2-weighted turbo spin echo (3000/80/echo train = 25) and contrast-enhanced T1-weighted images were compared with histopathologic findings. An autopsy case with hepatocellular carcinoma was also enrolled in this study.
All ablated regions showed three zones on T1-weighted FLASH images: a central zone with low intensity, a broad hyperintense middle zone, and a surrounding hypointense band. The central and middle zones corresponded to the degrees of coagulation necrosis observed during histopathologic examination, whereas no viable cells were seen in these zones during the microscopic examination using nicotinamide adenine dinucleotide diaphorase stain. The surrounding hypointense band corresponded to sinusoidal congestion in the acute phase and to fibrotic change in the subacute phase.
MR imaging using the FLASH sequence can accurately determine the extent of the necrotic area after RF ablation.
本研究的目的是与犬模型和尸检病例的组织病理学结果相比,评估磁共振(MR)成像在显示射频(RF)消融后肝脏真实组织坏死范围方面的效用。
在全身麻醉下对三只犬进行肝脏实质的射频消融。将射频消融区域在T1加权快速低角度激发(FLASH;重复时间/回波时间[TR/TE]/翻转角:120/3.8/70)、T2加权快速自旋回波(3000/80/回波链=25)和对比增强T1加权图像上的MR表现与组织病理学结果进行比较。本研究还纳入了一例肝细胞癌尸检病例。
所有消融区域在T1加权FLASH图像上均显示三个区域:中央低强度区、宽阔的高强度中间区和周围低强度带。中央区和中间区与组织病理学检查中观察到的凝固性坏死程度相对应,而在使用烟酰胺腺嘌呤二核苷酸黄递酶染色的显微镜检查中,这些区域未见活细胞。周围低强度带在急性期对应于窦状隙充血,在亚急性期对应于纤维化改变。
使用FLASH序列的MR成像能够准确确定射频消融后坏死区域的范围。