Departmentof Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
J Ultrasound Med. 2012 Jun;31(6):873-8. doi: 10.7863/jum.2012.31.6.873.
Our aim was to determine whether sonographically guided radiofrequency ablation with superficial saline injection can minimize thermal injury of the skin without an influence on therapeutic efficacy.
Institutional Animal Care Committee approval was obtained. Twelve percutaneous radiofrequency ablation procedures were performed in the thighs of 6 rabbits (control, n = 6, right thigh; experimental, n = 6, left thigh). The ablation with local anesthesia was performed in the most superficial area of the thigh muscle. In the experimental group, 1 mL of saline was injected before the ablation at the tissue layer between the skin and ablated muscle. The duration and energy of the ablation were the same in the control and experimental groups. Rabbits were compared for their gross skin state and histopathologic findings after the ablation.
The degree of thermal coagulation of the muscle was similar in both groups at pathologic examination. Grossly, skin redness was mild in the experimental group but moderate in the control group. Of the 6 rabbits, 5 tended to show more frequent histopathologic changes, including an inflammatory reaction, interruption of collagen fibers, injury of the skin adnexa, and fibrosis, in the control group when compared with the experimental group. However, there was no statistically significant difference (all P> .05). One rabbit that underwent ablation at higher energy had a partially dissected epidermis in the control group only.
Sonographically guided radiofrequency ablation with a saline injection superficial to a tumor might prevent skin burns and provide equivalent therapeutic efficacy for ablating superficial lesions.
本研究旨在确定在超声引导下经皮射频消融时于皮肤浅层注射生理盐水是否可以在不影响疗效的情况下最大限度地减少皮肤热损伤。
本研究获得了机构动物护理委员会的批准。6 只兔（对照组 n=6，右侧大腿；实验组 n=6，左侧大腿）的大腿中进行了 12 次经皮射频消融术。在大腿肌肉的最浅层进行局部麻醉下消融。实验组在消融前于皮肤与消融肌肉之间的组织层注射 1 mL 生理盐水。对照组和实验组的消融时间和能量相同。消融后比较两组兔子的大体皮肤状态和组织病理学发现。
病理检查显示两组肌肉的热凝固程度相似。大体上，实验组皮肤发红程度较轻，而对照组中度发红。6 只兔子中，与实验组相比，对照组有 5 只兔子更常出现组织病理学变化，包括炎症反应、胶原纤维中断、皮肤附属物损伤和纤维化，但无统计学差异（均 P＞0.05）。仅在对照组中，1 只接受高能量消融的兔子出现部分表皮分离。
超声引导下经皮射频消融时于肿瘤表面浅层注射生理盐水可能预防皮肤烧伤，并为消融表浅病变提供等效的治疗效果。
