Yoon J H, Lee J M, Woo S, Hwang E J, Hwang I, Choi W, Han J K, Choi B I
1 Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea.
Br J Radiol. 2015 Jun;88(1050):20140468. doi: 10.1259/bjr.20140468. Epub 2015 Apr 15.
To evaluate whether switching bipolar radiofrequency ablation (SB-RFA) using three internally cooled wet (ICW) electrodes can induce coagulations >5 cm in porcine livers with better efficiency than consecutive monopolar (CM) or switching monopolar (SM) modes.
A total of 60 coagulations were made in 15 in vivo porcine livers using three 17-gauge ICW electrodes and a multichannel radiofrequency (RF) generator. RF energy (approximately 200 W) was applied in CM mode (Group A, n = 20) for 24 min, SM mode for 12 min (Group B, n = 20) or switching bipolar (SB) mode for 12 min (Group C, n = 20) in in vivo porcine livers. Thereafter, the delivered RFA energy, as well as the shape and dimension of coagulations were compared among the groups.
Spherical- or oval-shaped ablations were created in 30% (6/20), 85% (17/20) and 90% (18/20) of coagulations in the CM, SM and SB groups, respectively (p = 0.003). SB-RFA created ablations >5 cm in minimum diameter (Dmin) in 65% (13/20) of porcine livers, whereas SM- or CM-RFA created ablations >5 cm in only 25% (5/20) and 20% (4/20) of porcine livers, respectively (p = 0.03). The mean Dmin of coagulations was significantly larger in Group C than in Groups A and B (5.1 ± 0.9, 3.9 ± 1.2 and 4.4 ± 1.0 cm, respectively, p = 0.002) at a lower delivered RF energy level (76.8 ± 14.3, 120.9 ± 24.5 and 114.2 ± 18.3 kJ, respectively, p < 0.001).
SB-RFA using three ICW electrodes can create coagulations >5 cm in diameter with better efficiency than do SM- or CM-RFA.
SB-RFA can create large, regular ablation zones with better time-energy efficiency than do CM- or SM-RFA.
评估使用三根内部冷却湿电极的双极射频消融术（SB-RFA）能否在猪肝中诱导形成直径大于5厘米的凝固灶，且效率高于连续单极（CM）或切换单极（SM）模式。
使用三根17号内部冷却湿电极和一台多通道射频（RF）发生器，在15只活体猪肝中总共进行60次凝固灶创建。在活体猪肝中，以CM模式（A组，n = 20）施加射频能量（约200瓦）24分钟，以SM模式施加12分钟（B组，n = 20），或以双极切换（SB）模式施加12分钟（C组，n = 20）。此后，比较各组所传递的射频消融能量以及凝固灶的形状和尺寸。
CM组、SM组和SB组分别有30%（6/20）、85%（17/20）和90%（18/20）的凝固灶呈球形或椭圆形（p = 0.003）。SB-RFA在65%（13/20）的猪肝中创建了最小直径（Dmin）大于5厘米的凝固灶，而SM-RFA和CM-RFA分别仅在25%（5/20）和20%（4/20）的猪肝中创建了直径大于5厘米的凝固灶（p = 0.03）。在较低的射频能量传递水平下（分别为76.8±14.3、120.9±24.5和114.2±18.3千焦，p < 0.001），C组凝固灶的平均Dmin显著大于A组和B组（分别为5.1±0.9、3.9±1.2和4.4±1.0厘米，p = 0.002）。
使用三根内部冷却湿电极的SB-RFA能够创建直径大于5厘米的凝固灶，且效率高于SM-RFA或CM-RFA。
与CM-RFA或SM-RFA相比，SB-RFA能够创建更大、更规则的消融区，且具有更好的时间-能量效率。
