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一种新型局部组织消融技术——不可逆电穿孔的体内实验结果

In vivo results of a new focal tissue ablation technique: irreversible electroporation.

作者信息

Edd Jon F, Horowitz Liana, Davalos Rafael V, Mir Lluis M, Rubinsky Boris

机构信息

Department of Mechanical Engineering, University of California, Berkeley, CA 94720, USA.

出版信息

IEEE Trans Biomed Eng. 2006 Jul;53(7):1409-15. doi: 10.1109/TBME.2006.873745.

Abstract

This paper reports results of in vivo experiments that confirm the feasibility of a new minimally invasive method for tissue ablation, irreversible electroporation (IRE). Electroporation is the generation of a destabilizing electric potential across biological membranes that causes the formation of nanoscale defects in the lipid bilayer. In IRE, these defects are permanent and lead to cell death. This paper builds on our earlier theoretical work and demonstrates that IRE can become an effective method for nonthermal tissue ablation requiring no drugs. To test the capability of IRE pulses to ablate tissue in a controlled fashion, we subjected the livers of male Sprague-Dawley rats to a single 20-ms-long square pulse of 1000 V/cm, which calculations had predicted would cause nonthermal IRE. Three hours after the pulse, treated areas in perfusion-fixed livers exhibited microvascular occlusion, endothelial cell necrosis, and diapedeses, resulting in ischemic damage to parenchyma and massive pooling of erythrocytes in sinusoids. However, large blood vessel architecture was preserved. Hepatocytes displayed blurred cell borders, pale eosinophilic cytoplasm, variable pyknosis and vacuolar degeneration. Mathematical analysis indicates that this damage was primarily nonthermal in nature and that sharp borders between affected and unaffected regions corresponded to electric fields of 300-500 V/cm.

摘要

本文报道了体内实验结果,证实了一种用于组织消融的新型微创方法——不可逆电穿孔(IRE)的可行性。电穿孔是在生物膜上产生不稳定的电势,导致脂质双层中形成纳米级缺陷。在不可逆电穿孔中,这些缺陷是永久性的,并导致细胞死亡。本文基于我们早期的理论工作,证明了不可逆电穿孔可以成为一种无需药物的非热组织消融的有效方法。为了测试不可逆电穿孔脉冲以可控方式消融组织的能力,我们对雄性Sprague-Dawley大鼠的肝脏施加了一个1000 V/cm、持续20毫秒的单方形脉冲,计算预测该脉冲会导致非热不可逆电穿孔。脉冲后三小时,灌注固定肝脏中的治疗区域出现微血管闭塞、内皮细胞坏死和血细胞渗出,导致实质缺血性损伤和红细胞在肝血窦中大量聚集。然而,大血管结构得以保留。肝细胞显示出模糊的细胞边界、淡嗜酸性细胞质、不同程度的核固缩和空泡变性。数学分析表明,这种损伤本质上主要是非热性的,受影响区域和未受影响区域之间的清晰边界对应于300 - 500 V/cm的电场。

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