Department of Diagnostic Radiology and Neuroradiology, Ernst-Moritz-Arndt-Universitaet Greifswald, Sauerbruchstraße, 17487 Greifswald, Germany.
Eur J Radiol. 2011 Nov;80(2):569-72. doi: 10.1016/j.ejrad.2010.05.017. Epub 2010 Jun 19.
Perfusion-mediated tissue cooling has often been described in the literature for thermal ablation therapies of liver tumors. The objective of this study was to investigate the cooling effects of both perfusion and ventilation during laser ablation of lung malignancies.
An ex vivo lung model was used to maintain near physiological conditions for the specimens. Fourteen human lung lobes containing only primary lung tumors (non-small cell lung cancer) were used. Laser ablation was carried out using a Nd:YAG laser with a wavelength of 1064 nm and laser fibers with 30 mm diffusing tips. Continuous invasive temperature measurement in 10 mm distance from the laser fiber was performed. Laser power was increased at 2 W increments starting at 10 W up to a maximum power of 12-20 W until a temperature plateau around 60 °C was reached at one sensor. Ventilation and perfusion were discontinued for 6 min each to assess their effects on temperature development.
The experiments lead to 25 usable temperature profiles. A significant temperature increase was observed for both discontinued ventilation and perfusion. In 6 min without perfusion, the temperature rose about 5.5 °C (mean value, P<0.05); without ventilation it increased about 7.0 °C (mean value, P<0.05).
Ventilation- and perfusion-mediated tissue cooling are significant influencing factors on temperature development during thermal ablation. They should be taken into account during the planning and preparation of minimally invasive lung tumor treatment in order to achieve complete ablation.
在肝脏肿瘤的热消融治疗中，文献中经常描述灌注介导的组织冷却。本研究的目的是研究激光消融肺部恶性肿瘤过程中灌注和通气对冷却的影响。
使用离体肺模型来维持标本的近生理条件。使用 14 个人类肺叶，其中仅包含原发性肺癌（非小细胞肺癌）。使用波长为 1064nm 的 Nd：YAG 激光和带有 30mm 扩散尖端的激光光纤进行激光消融。在距激光光纤 10mm 处进行连续侵入式温度测量。激光功率从 10W 以 2W 的增量增加，最高可达 12-20W，直到一个传感器周围达到 60°C 的温度平台。为了评估它们对温度发展的影响，暂停通气和灌注各 6 分钟。
该实验产生了 25 个可用的温度曲线。观察到暂停通气和灌注都会导致温度显著升高。在没有灌注的 6 分钟内，温度升高了约 5.5°C（平均值，P<0.05）；没有通气时，温度升高了约 7.0°C（平均值，P<0.05）。
通气和灌注介导的组织冷却是热消融过程中温度发展的重要影响因素。在计划和准备微创肺部肿瘤治疗时，应考虑到它们，以实现完全消融。
