Iwamoto Takuya, Kawai Nobuyuki, Sato Morio, Tanihata Hirohiko, Takasaka Isao, Minamiguchi Hiroki, Sahara Shinya, Nakata Kouhei, Shirai Shintaro
Department of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayamashi, Wakayama 641-8510, Japan.
J Vasc Interv Radiol. 2008 Nov;19(11):1646-51. doi: 10.1016/j.jvir.2008.08.015.
To evaluate the effectiveness of transcatheter arterial embolization (TAE) on radiofrequency (RF) ablation volume and compare portal vein (PV) flow and liver parenchymal pressure before and after treatment.
Eight healthy female swine were divided into four groups to be treated with RF ablation alone (RF-only group), RF ablation after TAE with gelatin sponge particles (GSPs; RF/TAE group), RF ablation after TAE with Lipiodol plus GSPs (RF/TAE/Lipiodol group), and PV embolization (PVE) with GSPs after TAE with Lipiodol plus GSPs (RF/TAE/Lipiodol/PVE group). Five ablations were created in each swine, with 10 ablations per group. A 2-cm expandable LeVeen needle electrode was used for RF ablation.
The greatest ablation volume (18,410.1 mm(3) +/- 3,986.4) was observed in the RF/TAE/Lipiodol/PVE group. Of the RF-only, RF/TAE, and RF/TAE/Lipiodol groups, the RF/TAE/Lipiodol group (14,835.5 mm(3) +/- 2,743.2) had a significantly larger ablation volume than the RF-only (8,002.6 mm(3) +/- 2,788.3) and RF/TAE groups (10,398.5 mm(3) +/- 2965.8; P < .05/3). PV pressures increased significantly after TAE (P < .01) compared with the pressure before TAE in the RF/TAE/Lipiodol and RF/TAE/Lipiodol/PVE groups, but not in the RF/TAE group. A marked increase in liver parenchymal pressure was seen during RF ablation; however, there were no significant differences among groups. Accumulation of Lipiodol was noted in the sinusoids in the RF/TAE/Lipiodol and RF/TAE/Lipiodol/PVE groups.
TAE with blockade of PV flow before RF ablation was associated with greater ablation volumes. Liver parenchymal pressure showed no correlation with increased ablation volume.
评估经导管动脉栓塞术（TAE）对射频（RF）消融体积的有效性，并比较治疗前后门静脉（PV）血流和肝实质压力。
将8只健康雌性猪分为四组，分别接受单纯射频消融治疗（单纯射频组）、用明胶海绵颗粒（GSPs）行TAE后进行射频消融（射频/TAE组）、用碘油加GSPs行TAE后进行射频消融（射频/TAE/碘油组）以及在用碘油加GSPs行TAE后用GSPs进行PV栓塞（PVE）（射频/TAE/碘油/PVE组）。每只猪进行5次消融，每组共10次消融。使用2厘米可扩张的LeVeen针电极进行射频消融。
在射频/TAE/碘油/PVE组中观察到最大的消融体积（18,410.1立方毫米±3,986.4）。在单纯射频组、射频/TAE组和射频/TAE/碘油组中，射频/TAE/碘油组（14,835.5立方毫米±2,743.2）的消融体积明显大于单纯射频组（8,002.6立方毫米±2,788.3）和射频/TAE组（10,398.5立方毫米±2,965.8；P<.05/3）。与射频/TAE/碘油组和射频/TAE/碘油/PVE组TAE前的压力相比，TAE后PV压力显著升高（P<.01），但射频/TAE组未出现这种情况。在射频消融期间观察到肝实质压力显著升高；然而，各组之间无显著差异。在射频/TAE/碘油组和射频/TAE/碘油/PVE组的肝血窦中发现碘油积聚。
在射频消融前用TAE阻断PV血流与更大的消融体积相关。肝实质压力与消融体积增加无关。
