Department of Medical Imaging and Interventional Radiology, The First Affiliated Hospital of NanChang University, NanChang, China.
Diagn Interv Radiol. 2013 Mar-Apr;19(2):145-9. doi: 10.4261/1305-3825.DIR.6093-12.1.
This study evaluated the influence of continuous infusion of diluted hydrochloric acid during radiofrequency ablation (RFA) on the size of ablated lesions.
Experiments were performed in 20 excised porcine livers using three different treatment modalities: (1) normal saline-enhanced RFA (NS-RFA), which was normal saline pumped into ablated tissue during RFA; (2) diluted hydrochloric acid ablation (DHAA), which was 3 mol/L diluted hydrochloric acid (HCl) injected into hepatic tissue without RFA; and (3) HCl-enhanced RFA (HCl-RFA), which was 3 mol/L diluted HCl continuously infused into ablated tissue during RFA. We produced 20 HCl-RFA and NS-RFA lesions, respectively, using a monopolar perfusion electrode connected to a commercially available radiofrequency generator, and 20 DHAA lesions using an 18-gauge Chiba needle. The ablated lesions were evaluated both macroscopically and histologically. Dimensions of lesions were compared among HCl-RFA, NS-RFA, and DHAA.
The ablated lesions had an elliptical-like shape and were well-demarcated with normal liver tissue. The mean volume, longitudinal diameter, and transverse diameter of NS-RFA lesions were 11.24±0.29 cm(3), 3.4±0.07 cm, and 2.48±0.03 cm, those of HCl-RFA lesions were 58.14±3.05 cm(3), 5.51±0.05 cm, and 4.49±0.11 cm, and those of DHAA lesions were 4.41±0.16 cm(3), 2.43±0.08 cm, and 1.8±0.03 cm, respectively. The mean dimensions of HCl-RFA lesions were the largest among the three types of ablation (P < 0.001).
Under the present experimental conditions, the continuous infusion of diluted HCl during RFA can generate larger ablated lesions than NS-RFA or DHAA in excised porcine livers.
本研究评估了在射频消融(RFA)过程中持续输注稀释盐酸对消融病灶大小的影响。
使用三种不同的治疗方式在 20 个离体猪肝中进行实验:(1)生理盐水增强 RFA(NS-RFA),即在 RFA 期间将生理盐水泵入消融组织中;(2)稀释盐酸消融(DHAA),即在无 RFA 的情况下将 3mol/L 稀释盐酸(HCl)注入肝组织中;以及(3)HCl 增强 RFA(HCl-RFA),即在 RFA 期间将 3mol/L 稀释 HCl 持续输注到消融组织中。我们分别使用与商业射频发生器相连的单极灌注电极产生 20 个 HCl-RFA 和 NS-RFA 病灶,以及使用 18 号 Chiba 针产生 20 个 DHAA 病灶。通过宏观和组织学评估消融病灶。比较 HCl-RFA、NS-RFA 和 DHAA 之间的病灶尺寸。
消融病灶呈椭圆形,与正常肝组织界限分明。NS-RFA 病灶的平均体积、纵径和横径分别为 11.24±0.29cm3、3.4±0.07cm 和 2.48±0.03cm,HCl-RFA 病灶的平均体积、纵径和横径分别为 58.14±3.05cm3、5.51±0.05cm 和 4.49±0.11cm,DHAA 病灶的平均体积、纵径和横径分别为 4.41±0.16cm3、2.43±0.08cm 和 1.8±0.03cm。在这三种消融方式中,HCl-RFA 病灶的平均尺寸最大(P < 0.001)。
在目前的实验条件下,与 NS-RFA 或 DHAA 相比,在离体猪肝中 RFA 过程中持续输注稀释 HCl 可产生更大的消融病灶。