Hines-Peralta Andrew U, Pirani Nadeer, Clegg Peter, Cronin Nigel, Ryan Thomas P, Liu Zhenjun, Goldberg S Nahum
Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, 1 Deaconess Rd, WCC 308B, Boston, MA 02215, USA.
Radiology. 2006 Apr;239(1):94-102. doi: 10.1148/radiol.2383050262. Epub 2006 Feb 16.
To characterize the relationship between applied power and treatment duration in their effect on extent of coagulation produced with a 2.45-GHz microwave applicator in both an ex vivo and a perfused in vivo liver model.
All experimentation was approved by the Institute of Animal Care and Use Committee. Multiple tissue ablations were performed in ex vivo bovine liver (120 ablations) and in vivo porcine liver (45 ablations) with a 5.7-mm-diameter 2.45-GHz microwave applicator. The applied power was varied from 50 to 150 W (in 25-W increments ex vivo and 50-W increments in vivo), while treatment duration varied from 2 to 20 minutes (in eight time increments for ex vivo and five for in vivo liver). Three-dimensional contour maps of the resultant short- and long-axis coagulation diameters were constructed to identify the optimal parameters to achieve maximum coagulation in both ex vivo and in vivo models. Multivariate analysis was performed to characterize the relationship between applied power and treatment duration.
Power and treatment duration were both associated with coagulation diameter in a sigmoidal fashion (ex vivo, R(2) = 0.78; in vivo, R(2) = 0.74). For ex vivo liver, the maximum short-axis coagulation diameter (7.6 cm +/- 0.2 [standard deviation] by 12.3 cm +/- 0.8) was achieved at greatest power (150 W) and duration (20 minutes). In vivo studies revealed a sigmoidal relationship between duration and coagulation size, with a relative plateau in coagulation size achieved within 8 minutes duration at all power levels. After 8 minutes of treatment at 150 W, the mean short-axis coagulation diameter for in vivo liver was 5.7 cm +/- 0.2 by 6.5 cm +/- 1.7, which was significantly larger than the corresponding result for ex vivo liver (P < .05).
Large zones of ablation can be achieved with the 2.45-GHz microwave applicator used by the authors. For higher-power ablations, larger zones of coagulation were achieved for in vivo liver than for ex vivo liver with short energy applications, a finding previously not seen with other ablation devices, to the authors' knowledge.
在离体和灌注活体肝脏模型中,研究2.45 GHz微波施加器所施加的功率与治疗持续时间对凝血范围的影响之间的关系。
所有实验均经动物护理与使用委员会批准。使用直径为5.7 mm的2.45 GHz微波施加器,在离体牛肝(120次消融)和活体猪肝(45次消融)上进行多次组织消融。施加的功率在50至150 W之间变化(离体时以25 W为增量,活体时以50 W为增量),而治疗持续时间在2至20分钟之间变化(离体肝脏分8个时间增量,活体肝脏分5个时间增量)。构建所得短轴和长轴凝血直径的三维轮廓图,以确定在离体和活体模型中实现最大凝血的最佳参数。进行多变量分析以描述施加功率与治疗持续时间之间的关系。
功率和治疗持续时间均与凝血直径呈S形相关(离体,R² = 0.78;活体,R² = 0.74)。对于离体肝脏,在最大功率(150 W)和最长持续时间(20分钟)时,实现了最大短轴凝血直径(7.6 cm±0.2 [标准差]×12.3 cm±0.8)。活体研究显示持续时间与凝血大小之间呈S形关系,在所有功率水平下,8分钟内凝血大小达到相对平稳状态。在150 W下治疗8分钟后,活体肝脏的平均短轴凝血直径为5.7 cm±0.2×6.5 cm±1.7,显著大于离体肝脏的相应结果(P <.05)。
作者使用的2.45 GHz微波施加器可实现大面积消融。据作者所知,对于高功率消融,在短时间能量应用下,活体肝脏的凝血区域比离体肝脏更大,这一发现是其他消融设备以前未曾见到的。