Oshima Fumiyoshi, Yamakado Koichiro, Akeboshi Masao, Takaki Haruyuki, Nakatsuka Atsuhiro, Makita Masashi, Takeda Kan
Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan.
J Vasc Interv Radiol. 2004 Dec;15(12):1451-6. doi: 10.1097/01.RVI.0000140640.87399.58.
This study was undertaken to compare the thermal lesion volumes in normal pig lungs when radiofrequency (RF) ablation is performed with and without airway occlusion.
RF ablation was performed in six pigs. A straight 17-gauge internally cooled-tip electrode with a 2-cm exposed tip was inserted into the center of the lower lobe of the lung under biplane fluoroscopic guidance. In each animal, RF ablation was performed for 12 minutes with balloon occlusion of the main bronchus in one lung and without balloon occlusion in the contralateral lung. The tissue temperature around the electrode tip was measured immediately after RF application. The volumes of the thermal lesions were compared by histologic examination of the groups of lungs ablated with and without airway occlusion.
Tissue temperature was significantly higher in the bronchial occlusion group than in the group with normal ventilation (51 degrees C +/- 7 vs. 44 degrees C +/- 2; P < .05). RF ablation with bronchial occlusion resulted in the creation of a significantly greater thermal lesion volume compared with RF ablation with normal ventilation (6,535 mm(3) +/- 1,114 vs 3,368 mm(3) +/- 676; P < .03).
Prevention of ventilation in the normal swine lung via bronchial balloon occlusion during RF ablation increases the thermal ablation lesion volume, suggesting that active ventilation is a significant cause of in vivo heat loss.
本研究旨在比较在有或没有气道阻塞的情况下对正常猪肺进行射频(RF)消融时的热损伤体积。
对6头猪进行射频消融。在双平面荧光透视引导下,将一根外露尖端为2 cm的17号直形内部冷却尖端电极插入肺下叶中心。在每只动物中,一侧肺通过球囊阻塞主支气管进行12分钟的射频消融,对侧肺不进行球囊阻塞。射频应用后立即测量电极尖端周围的组织温度。通过对有气道阻塞和无气道阻塞的消融肺组进行组织学检查来比较热损伤体积。
支气管阻塞组的组织温度显著高于正常通气组(51℃±7 对比 44℃±2;P <.05)。与正常通气的射频消融相比,支气管阻塞的射频消融导致产生的热损伤体积显著更大(6535 mm³±1114 对比 3368 mm³±676;P <.03)。
在射频消融期间通过支气管球囊阻塞防止正常猪肺通气可增加热消融损伤体积,表明主动通气是体内热量损失的一个重要原因。