Sato Shuichi, Miyake Tatsuya, Mishiro Tomoko, Furuta Kohichiro, Azumi Takane, Oshima Naoki, Takahashi Yoshiko, Rumi Mohammad A K, Ishihara Shunnji, Adachi Kyoichi, Amano Yuji, Kinoshita Yoshikazu
Department of Gastroenterology and Hepatology, Shimane University School of Medicine, Izumo, Shimane, Japan.
J Gastroenterol Hepatol. 2006 Nov;21(11):1714-9. doi: 10.1111/j.1440-1746.2006.04417.x.
The size of radiofrequency ablation (RFA) in the liver can be negatively influenced by the surrounding blood flow. The indocyanine green (ICG) test can be used to evaluate the effective blood flow in the liver, and distance from the hilus can affect local blood flow. The aim of this study was to assess whether the ICG test or distance from the hilus could be used to predict the size of the ablated area in liver by RFA treatment of hepatocellular carcinoma (HCC) nodules.
The RFA measurements of 44 HCC nodules in 39 patients were retrospectively studied. Cases were included if they met the following criteria: (i) no catheter treatment before RFA; (ii) no movement of the RFA device; (iii) strict ablation time; and (iv) only one ablation. In all patients, ICG-R15 testing was done immediately before RFA and the initial therapeutic efficacy was evaluated by dynamic computed tomography scanning 2-5 days after RFA. The correlation between the maximum size of the RFA area and the ICG test results or the distance of the target area from the hilus (site of first portal vein divergence) were analyzed statistically.
The ICG-R15 result was significantly correlated with the maximum diameter of the ablated area both in 2 cm-electrode tip length (R2 = 0.35, P = 0.0012), and in 3 cm-tip length (R2 = 0.26, P = 0.0377). Multiple-regression analysis showed that the electrode tip length (P = 0.0010) and ICG-R15 (P = 0.0046) were independent factors that could predict the maximum diameter of the RFA area.
The results of ICG testing can be used to predict the size of the area that will be ablated at a target liver site before RFA treatment.
肝脏射频消融（RFA）的范围可能会受到周围血流的负面影响。吲哚菁绿（ICG）试验可用于评估肝脏的有效血流，且距肝门的距离会影响局部血流。本研究的目的是评估ICG试验或距肝门的距离是否可用于预测肝细胞癌（HCC）结节经RFA治疗后肝脏消融区域的大小。
对39例患者的44个HCC结节的RFA测量结果进行回顾性研究。符合以下标准的病例纳入研究：（i）RFA治疗前未进行导管治疗；（ii）RFA设备无移动；（iii）严格的消融时间；（iv）仅进行一次消融。所有患者在RFA治疗前立即进行ICG-R15检测，并在RFA治疗后2-5天通过动态计算机断层扫描评估初始治疗效果。对RFA区域的最大尺寸与ICG试验结果或靶区距肝门（第一门静脉分支部位）的距离之间的相关性进行统计学分析。
在电极尖端长度为2 cm时（R2 = 0.35，P = 0.0012）以及电极尖端长度为3 cm时（R2 = 0.26，P = 0.0377），ICG-R15结果均与消融区域的最大直径显著相关。多元回归分析显示，电极尖端长度（P = 0.0010）和ICG-R15（P = 0.0046）是可预测RFA区域最大直径的独立因素。
ICG试验结果可用于预测RFA治疗前肝脏靶部位将被消融的区域大小。
