The Institute of Hepatobiliary Surgery, Southwest Hospital, Third Military Medical University, Chongqing, China.
Int J Hyperthermia. 2011;27(2):116-23. doi: 10.3109/02656736.2010.508762. Epub 2010 Nov 19.
The heat-sink effect produced by rapid blood flow through large vessels (diameter (D) ≥ 5 mm) is an important factor that influences ablation zone size after radiofrequency ablation (RFA). Currently, however, the interactions between hepatic RFA lesions and large vessels are not well understood. The purpose of this study was to examine the effects of RFA lesions occurring near large vessels (D ≥ 5 mm) in the canine liver.
Thirty healthy adult mongrel dogs were used, with 15 dogs randomly assigned to groups I and II. In group I, the closest distance from the tip of the RFA electrode to the large vessel (D ≥ 5 mm) was more than 20 mm; in group II, this distance to the wall of the inferior vena cava (IVC) was no more than 5 mm. RFA was performed on the liver of each dog according to standard procedures. The blood flow velocity of the IVC, the computerised tomography (CT), the pathological characteristics of the RFA lesions and procedure-related complications were examined.
No death or complications occurred in any dogs. Vascular walls were not affected, except for when the tips of the electrode stuck to the IVC. The coagulative necrosis region was decreased, and its shape was fusiform close to the IVC. Some normal hepatic cells were found in the necrotic region near the IVC.
It is both safe and feasible to perform RFA near the IVC. The shape and size of the coagulation zone should be considered when electrodes are placed in this area. Near the IVC, the size of the coagulation zone was decreased, and it was incompletely formed.
快速血流通过大血管（直径（D）≥5mm）产生的热沉效应是影响射频消融（RFA）后消融区域大小的一个重要因素。然而，目前对于肝 RFA 病变与大血管之间的相互作用尚不完全清楚。本研究旨在研究犬肝内靠近大血管（D≥5mm）的 RFA 病变的影响。
使用 30 只健康成年杂种犬，其中 15 只犬随机分为 I 组和 II 组。在 I 组中，RFA 电极尖端与大血管（D≥5mm）的最近距离超过 20mm；在 II 组中，与下腔静脉（IVC）壁的距离不超过 5mm。根据标准程序对每只狗的肝脏进行 RFA。检查 IVC 的血流速度、计算机断层扫描（CT）、RFA 病变的病理特征和与程序相关的并发症。
没有狗死亡或发生并发症。除了电极尖端粘在 IVC 上之外，血管壁没有受到影响。凝固性坏死区域减小，形状呈梭形靠近 IVC。在靠近 IVC 的坏死区域发现了一些正常的肝细胞。
在 IVC 附近进行 RFA 既安全又可行。在该区域放置电极时，应考虑凝固区的形状和大小。靠近 IVC 时，凝固区的大小减小，且不完全形成。
