Nakai Motoki, Sato Morio, Sahara Shinya, Kawai Nobuyuki, Tanihata Hirohiko, Kimura Masashi, Terada Masaki
Department of Radiology, Hidaka General Hospital, 116-2 Sono, Gobo Shi, Wakayama 644-8655, Japan.
World J Gastroenterol. 2007 May 28;13(20):2841-5. doi: 10.3748/wjg.v13.i20.2841.
To evaluate the effects of combined radiofrequency ablation and transcatheter arterial embolization with iodized oil on ablation time, maximum output, coagulation diameter, and portal angiography in a porcine liver model.
Radiofrequency ablation (RFA) was applied to in vivo livers of 10 normal pigs using a 17-gauge 3.0 cm expandable LeVeen RF needle electrode with or without transcatheter arterial embolization (TAE) with iodized oil (n=5). In each animal, 2 areas in the liver were ablated. Direct portography was performed before and after RFA. Ablation was initiated at an output of 30 W, and continued with an increase of 10 W per minute until roll-off occurred. Ablation time and maximum output until roll-off, and coagulated tissue diameter were compared between the 2 groups. Angiographic changes on portography before and after ablation were also reviewed.
For groups with and without TAE with iodized oil, the ablation times until roll-off were 320.6 +/- 30.9 seconds and 445.1 +/- 35.9 seconds, respectively, maximum outputs were 69.0 +/- 7.38 W and 87.0 +/- 4.83 W and maximal diameters of coagulation were 41.7 +/- 3.85 mm and 33.2 +/- 2.28 mm. Significant reductions of ablation time and maximum output, and significantly larger coagulation diameter were obtained with RFA following TAE with iodized oil compared to RFA alone. Portography after RFA following TAE with iodized oil revealed more occlusion of the larger portal branches than with RFA alone.
RFA following TAE with iodized oil can increase the volume of coagulation necrosis with lower output and shorter ablation time than RFA alone in normal pig liver tissue.
在猪肝模型中评估联合射频消融与碘油经导管动脉栓塞术对消融时间、最大输出功率、凝固直径和门静脉血管造影的影响。
使用17G 3.0 cm可扩张LeVeen射频针电极,对10只正常猪的活体肝脏进行射频消融(RFA),其中5只同时进行碘油经导管动脉栓塞术(TAE)。在每只动物的肝脏中消融2个区域。在RFA前后进行直接门静脉造影。以30 W的输出功率开始消融,并以每分钟增加10 W的速度持续进行,直至出现功率下降。比较两组的消融时间、功率下降前的最大输出功率以及凝固组织直径。还回顾了消融前后门静脉造影的血管造影变化。
对于使用碘油进行TAE组和未使用碘油进行TAE组,功率下降前的消融时间分别为320.6±30.9秒和445.1±35.9秒,最大输出功率分别为69.0±7.38 W和87.0±4.83 W,最大凝固直径分别为41.7±3.85 mm和33.2±2.28 mm。与单纯RFA相比,碘油TAE联合RFA可显著缩短消融时间、降低最大输出功率,并显著增加凝固直径。碘油TAE联合RFA后的门静脉造影显示,较大门静脉分支的闭塞比单纯RFA更多。
在正常猪肝组织中,碘油TAE联合RFA与单纯RFA相比,能够以更低的输出功率和更短的消融时间增加凝固性坏死的体积。