Lee Jeong Min, Han Joon Koo, Chang Jung Min, Chung Se Young, Son Kyu Ri, Kim Se Hyung, Lee Jae Young, Choi Byung Ihn
Department of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, Chongno-gu, Korea.
J Vasc Interv Radiol. 2006 Mar;17(3):549-56. doi: 10.1097/01.rvi.0000202713.07943.fc.
To evaluate the in vivo efficiency of radiofrequency ablation using an internally cooled-perfusion (ICP) electrode for inducing coagulation necrosis compared with those of RFA using internally cooled or multitined expandable electrodes in porcine kidneys.
Using a 200 W generator and internally cooled and ICP electrodes or a 150 W generator and a multitined expandable electrode, a total of 15 radiofrequency ablations were performed in the kidneys of nine pigs. After placement of an electrode in the lower pole of a kidney, one ablation zone was created using one of three different regimens: group A, radiofrequency ablation using an internally cooled electrode; group B, radiofrequency ablation using an ICP electrode with 14.6% NaCl solution instillation at 1 mL/minute; group C, radiofrequency ablation using a multitined expandable electrode. Three days after the procedures, contrast-enhanced CT scans were obtained to evaluate ablation region volumes, and kidneys were harvested for gross measurements. The three groups were compared with respect to technical parameters such as changes in impedance and current during radiofrequency ablation. The dimensions of thermal ablation zones created in the three groups were compared histologically.
In vivo study showed that ICP electrode allowed a greater energy delivery than internally cooled or multitined expandable electrode during radiofrequency ablation: 63.3 +/- 8.8 kJ in group A; 101 +/- 3.3 kJ in group B; and 61.8 +/- 12.5 kJ (P < .05). In vivo studies showed radiofrequency ablation using ICP electrode achieved larger mean coagulation volumes than radiofrequency ablation using the other electrodes: 12.0 +/- 3.9 cm(3) in group A; 30.5 +/- 7.6 cm(3) in group B; and 11.6 +/- 6.7 cm(3) in group C (P < .05). In addition, group B had a larger mean short-axis diameter of radiofrequency-induced coagulation necrosis than groups A or C: 2.6 +/- 0.5 cm in group A; 3.6 +/- 0.4 cm in group B; and 2.4 +/- 0.7 cm in group C (difference between groups B and C: P < .05).
Radiofrequency ablation using an ICP electrode showed better performance at creating coagulation necrosis than radiofrequency ablation using internally cooled or multitined expandable electrodes in this porcine renal model.
评估使用内部冷却灌注（ICP）电极进行射频消融诱导凝固性坏死的体内效率，并与在猪肾中使用内部冷却电极或多针可扩张电极进行射频消融的效率进行比较。
使用一台200W发生器及内部冷却电极和ICP电极，或一台150W发生器及多针可扩张电极，在9头猪的肾脏中总共进行了15次射频消融。将电极置于肾脏下极后，采用三种不同方案之一创建一个消融区：A组，使用内部冷却电极进行射频消融；B组，使用ICP电极并以1mL/分钟的速度滴注14.6%氯化钠溶液进行射频消融；C组，使用多针可扩张电极进行射频消融。操作后三天，进行对比增强CT扫描以评估消融区体积，并摘取肾脏进行大体测量。比较三组在射频消融过程中的阻抗和电流等技术参数。对三组产生的热消融区尺寸进行组织学比较。
体内研究表明，在射频消融过程中，ICP电极比内部冷却电极或多针可扩张电极能传递更多能量：A组为63.3±8.8kJ；B组为101±3.3kJ；C组为61.8±12.5kJ（P<.05）。体内研究显示，使用ICP电极进行射频消融比使用其他电极实现的平均凝固体积更大：A组为12.0±3.9cm³；B组为30.5±7.6cm³；C组为11.6±6.7cm³（P<.05）。此外，B组射频诱导的凝固性坏死平均短轴直径大于A组或C组：A组为2.6±0.5cm；B组为3.6±0.4cm；C组为2.4±0.7cm（B组与C组之间差异：P<.05）。
在该猪肾模型中，使用ICP电极进行射频消融在产生凝固性坏死方面比使用内部冷却电极或多针可扩张电极表现更好。
