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门静脉血流变化对肝血流灌注牛模型中射频和微波消融的影响。

Effect of variation of portal venous blood flow on radiofrequency and microwave ablations in a blood-perfused bovine liver model.

机构信息

Department of Radiology, School of Medicine, University of Colorado, Mail Stop L954, 12401 E 17th Ave, PO Box 6510, Aurora, CO 80045, USA.

出版信息

Radiology. 2013 Apr;267(1):129-36. doi: 10.1148/radiol.12120486. Epub 2013 Jan 7.

Abstract

PURPOSE

To assess whether there is a significant difference in the effect of incremental changes of portal venous blood flow rates on the size of radiofrequency (RF) versus microwave (MW) ablation lesions in an ex vivo blood-perfused bovine liver model.

MATERIALS AND METHODS

This study was exempt from approval by the Institutional Animal Care and Use Committee. Sixty ablations (30 MW and 30 RF ablations) were performed ex vivo in 15 bovine livers perfused with autologous blood via the portal vein at 60, 70, 80, 90, and 100 mL/min per 100 g of liver tissue (three livers were used for each flow rate). Long-axis diameter (LAD), short-axis diameter (SAD), and volume were measured for each ablation lesion. A general linear mixed model was used to examine the effect of location, ablation device, and flow rate on LAD, SAD, and volume. Results were considered to indicate a significant difference at P less than .05.

RESULTS

Location was not a significant predictor of LAD, SAD, or volume (P ≥ .4). The slope of the relationship between flow rate and LAD, SAD, and volume was significantly different according to ablation device (P < .0001). For RF ablation lesions, the mean LAD, SAD, and volume demonstrated a significant inverse relationship with flow rate, while the measurements for MW ablation did not change with variation in flow rates.

CONCLUSION

The size of RF ablation lesions is highly variable, with a significant inverse relationship to the rate of portal venous blood flow. Conversely, the size of MW ablation lesions is unaffected by changes in portal venous blood flow. The consistency of the size of MW ablation lesions could translate into a higher local tumor eradication rate than that reported with RF ablation.

摘要

目的

在离体经门静脉血流灌注牛肝模型中,评估门静脉血流率的递增变化对射频(RF)与微波(MW)消融灶大小的影响是否存在显著差异。

材料与方法

本研究获得机构动物护理和使用委员会批准豁免。在 15 个离体牛肝中,通过门静脉以 60、70、80、90 和 100 mL/min/100 g 肝组织的速度灌注自体血液,进行 60 个 RF (30 个)和 MW (30 个)消融术。每个消融灶测量长轴直径(LAD)、短轴直径(SAD)和体积。采用一般线性混合模型检查位置、消融设备和流速对 LAD、SAD 和体积的影响。结果 P<0.05 时认为差异具有统计学意义。

结果

位置不是 LAD、SAD 或体积的显著预测因子(P≥0.4)。根据消融设备,流速与 LAD、SAD 和体积之间的关系斜率具有显著差异(P<0.0001)。对于 RF 消融灶,LAD、SAD 和体积的平均值与流速呈显著负相关,而 MW 消融的测量值不随流速变化而变化。

结论

RF 消融灶的大小变化很大,与门静脉血流率呈显著负相关。相反,MW 消融灶的大小不受门静脉血流变化的影响。MW 消融灶大小的一致性可能转化为比 RF 消融更高的局部肿瘤消除率。

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