Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany.
J Vasc Interv Radiol. 2013 Aug;24(8):1241-8. doi: 10.1016/j.jvir.2013.04.008. Epub 2013 Jun 20.
To quantify the extent of tissue shrinkage and dehydration caused by microwave (MW) ablation in kidneys for estimation of effective coagulation volume.
MW ablations were carried out in ex vivo porcine kidneys. Six study groups were defined: groups 1A, 2A, and 3A for MW ablation (90 W for 5 min, 7.5 min, or 10 min), and groups 1B, 2B, and 3B for control (without MW ablation). Pre- and postinterventional volume analyses were performed. Effective coagulation volumes (original tissue included in coagulation) were determined. Postinterventional dehydration analyses were performed with calculation of mean mass fractions of water.
Mean deployed energies were 21.6 kJ ± 1.1 for group 1A, 29.9 kJ ± 1.0 for group 2A, and 42.1 kJ ± 0.5 kJ for group 3A, and were significantly different (P < .0001). Differences between pre- and postinterventional volumes were -3.8% ± 0.6 for group 1A, -5.6% ± 0.9 for group 2A, and -7.2% ± 0.4 for group 3A, and -1.1% ± 0.3 for group 1B, -1.8% ± 0.4 for group 2B, and -1.1% ± 0.4 for group 3B. Postinterventional volumes were significantly smaller than preinterventional volumes for all groups (P < .01). Underestimations of effective coagulation volume from visualized coagulation volume were 26.1% ± 3.5 for group 1A, 35.2% ± 11.2 for group 2A, and 42.1% ± 4.9 for group 3A, which were significantly different (P < .01). Mean mass fractions of water were 64.2% ± 1.4 for group 1A, 63.2% ± 1.7 for group 2A, and 62.6% ± 1.8% for group 3A, with significant differences versus corresponding control groups (P < .01).
For MW ablation in kidneys, underestimation of effective coagulation volume based on visualized coagulation volume is significantly greater with greater deployed energy. Therefore, local dehydration with tissue shrinkage is a potential contributor.
量化微波(MW)消融在肾脏组织中引起的组织收缩和脱水程度,以估计有效凝血体积。
在离体猪肾中进行 MW 消融。定义了 6 个研究组:MW 消融组 1A、2A 和 3A(90 W 消融 5 分钟、7.5 分钟或 10 分钟),对照组 1B、2B 和 3B(无 MW 消融)。进行介入前后的体积分析。确定了有效凝血体积(包含在凝血中的原始组织)。进行介入后脱水分析,计算平均水质量分数。
MW 消融组 1A、2A 和 3A 的平均能量分别为 21.6 kJ ± 1.1、29.9 kJ ± 1.0 和 42.1 kJ ± 0.5 kJ,差异具有统计学意义(P <.0001)。MW 消融组 1A、2A 和 3A 的介入前后体积差异分别为-3.8% ± 0.6、-5.6% ± 0.9 和-7.2% ± 0.4,而对照组 1B、2B 和 3B 的差异分别为-1.1% ± 0.3、-1.8% ± 0.4 和-1.1% ± 0.4。所有组的介入后体积均明显小于介入前体积(P <.01)。MW 消融组 1A、2A 和 3A 的有效凝血体积相对于可见凝血体积的估计不足分别为 26.1% ± 3.5、35.2% ± 11.2 和 42.1% ± 4.9,差异具有统计学意义(P <.01)。MW 消融组 1A、2A 和 3A 的平均水质量分数分别为 64.2% ± 1.4、63.2% ± 1.7 和 62.6% ± 1.8%,与相应的对照组相比差异均有统计学意义(P <.01)。
对于肾脏的 MW 消融,基于可见凝血体积的有效凝血体积的低估与更大的能量部署显著相关。因此,组织收缩引起的局部脱水可能是一个潜在的贡献因素。