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兔肝脏射频消融后的CT表现:内部冷却电极、灌注电极及内部冷却灌注电极的比较

CT findings after radiofrequency ablation in rabbit livers: comparison of internally cooled electrodes, perfusion electrodes, and internally cooled perfusion electrodes.

作者信息

Kim Seung Kwon, Gu Myung Seo, Hong Hyun Pyo, Choi Dongil, Chae Seoung Wan

机构信息

Deparment of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 180 Pyung-Dong, Jongro-Ku, Seoul 110-746, South Korea.

出版信息

J Vasc Interv Radiol. 2007 Nov;18(11):1417-27. doi: 10.1016/j.jvir.2007.08.010.

Abstract

PURPOSE

To compare the computed tomography (CT) findings of radiofrequency (RF) ablation of rabbit livers with the use of internally cooled electrodes, perfusion electrodes, and internally cooled perfusion (ICP) electrodes.

MATERIALS AND METHODS

RF ablation zones were created in 24 rabbit livers in vivo in three groups, each treated at 30 W for 30 minutes with an electrode with a 1-cm active portion: one group was treated with an internally cooled electrode (group A), one with a perfusion electrode (group B), and one with an ICP electrode (group C). In the latter two groups, 0.9% saline solution mixed with contrast medium (9:1 ratio) was infused at a rate of 1 mL/min. Immediate CT images were ascertained in all groups and follow-up CT was performed in the latter two groups. CT findings of the RF ablation zone and surrounding liver parenchyma were evaluated and compared among groups.

RESULTS

On immediate unenhanced CT, infused contrast medium was noted in the center of the ablation zone without extravasation. Marginal linear or tubular low densities of the RF ablation zone were noted only in groups B (n=4) and C (n=3). Liver infarction was more frequently noted in groups B (n=5) and C (n=7) than in group A (n=3). Periportal tracking was noted more frequently in groups B (n=7) and C (n=8) than in group A (n=1). Pericaval or perihepatic tracking was noted only in groups B (n=3) and C (n=3). Extensive portal venous gas was noted in one animal in group C.

CONCLUSIONS

On CT, RF ablation with the perfusion or ICP electrode seemed to show more severe surrounding parenchymal changes than RF ablation with an internally cooled electrode.

摘要

目的

比较使用内部冷却电极、灌注电极和内部冷却灌注(ICP)电极对兔肝脏进行射频(RF)消融后的计算机断层扫描(CT)结果。

材料与方法

在24只兔肝脏内进行体内RF消融区创建,分为三组,每组使用活性部分为1厘米的电极,以30瓦功率治疗30分钟:一组使用内部冷却电极(A组),一组使用灌注电极(B组),一组使用ICP电极(C组)。在后两组中,将0.9%生理盐水与造影剂按9:1比例混合,以1毫升/分钟的速度注入。所有组均获取即时CT图像,后两组进行随访CT检查。评估并比较各组RF消融区及周围肝实质的CT表现。

结果

在即时平扫CT上,消融区中心可见注入的造影剂,无外渗。仅在B组(n = 4)和C组(n = 3)中观察到RF消融区边缘呈线性或管状低密度影。B组(n = 5)和C组(n = 7)比A组(n = 3)更频繁地观察到肝梗死。B组(n = 7)和C组(n = 8)比A组(n = 1)更频繁地观察到门静脉周围蔓延。仅在B组(n = 3)和C组(n = 3)中观察到腔静脉周围或肝周蔓延。C组有一只动物出现广泛门静脉积气。

结论

在CT上,使用灌注或ICP电极进行RF消融似乎比使用内部冷却电极进行RF消融显示出更严重的周围实质改变。

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