Permpongkosol Sompol, Nicol Theresa L, Link Richard E, Varkarakis Ioannis, Khurana Hema, Zhai Qihui Jim, Kavoussi Louis R, Solomon Stephen B
James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Johns Hopkins Hospital, Baltimore, MD, USA.
AJR Am J Roentgenol. 2007 Apr;188(4):1028-32. doi: 10.2214/AJR.06.0810.
The purpose of our study was to assess the variation in size of acute necrosis and the variation in thermal map measured during cryoablation in multiple organs using the same ablation protocol for each organ.
Eight female pigs underwent one cryoablation per organ of kidney, lung, and liver performed with open surgery with a 2.4-mm cryoprobe. A 12- and 8-minute double-freeze cycle was used. Intratissue temperatures were monitored using 16-gauge thermometers spaced at 5.0-mm increments from the cryoprobe. The comparison of results among tissues was performed using the multiple analysis of variance. The -20 degrees C thermal diameter was correlated with tissue damage. The kidneys, lungs, and liver were removed and examined histologically for a pathologic complete coagulative necrosis zone.
A single 2.4-mm cryoprobe had a mean ice ball diameter in kidney, lung, and liver of 38.5 +/- 4.7, 35.5 +/- 3.6, and 32.5 +/- 2.7 mm, respectively. A mean -20 degrees C thermal diameter was achieved at 24.07 +/- 1.38 mm in kidney, 12.76 +/- 3.0 mm in lung, and 8.8 +/- 3.7 mm in liver by means of regression analysis. The acute pathologic complete coagulative necrosis zone size was 21.0 +/- 1.56 mm (kidney), 11.6 +/- 1.48 mm (lung), and 8.0 +/- 1.20 mm (liver).
The inherent characteristics of different organs manifest different ablation zone sizes during cryoablation despite the same ablation protocol being used. This information should be factored into planning for ablation procedures.
我们研究的目的是评估在对多个器官进行冷冻消融时,使用相同的消融方案,急性坏死灶大小的变化以及热图的变化。
八只雌性猪,每个器官(肾脏、肺和肝脏)进行一次冷冻消融,采用开放手术,使用2.4毫米的冷冻探头。采用12分钟和8分钟的双冻融循环。使用16号温度计监测组织内温度,温度计距冷冻探头以5.0毫米的增量间隔排列。使用多因素方差分析对不同组织的结果进行比较。-20℃热直径与组织损伤相关。切除肾脏、肺和肝脏,进行组织学检查,以确定病理完全凝固性坏死区。
单个2.4毫米冷冻探头在肾脏、肺和肝脏中的平均冰球直径分别为38.5±4.7毫米、35.5±3.6毫米和32.5±2.7毫米。通过回归分析,在肾脏中达到-20℃的平均热直径为24.07±1.38毫米,在肺中为12.76±3.0毫米,在肝脏中为8.8±3.7毫米。急性病理完全凝固性坏死区大小在肾脏中为21.0±1.56毫米,在肺中为11.6±1.48毫米,在肝脏中为8.0±1.20毫米。
尽管使用相同的消融方案,但不同器官的固有特性在冷冻消融过程中表现出不同的消融区大小。在规划消融手术时应考虑到这些信息。