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人体尸体模型中脊柱转移瘤射频消融过程中的温度分布:三种电极的比较

Temperature distribution during radiofrequency ablation of spinal metastases in a human cadaver model: Comparison of three electrodes.

作者信息

Bornemann Rahel, Pflugmacher Robert, Frey Sönke P, Roessler Philip P, Rommelspacher Yorck, Wilhelm Kai E, Sander Kirsten, Wirtz Dieter C, Grötz Simon F

机构信息

Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn, Bonn, Germany.

Fachabteilung Radiologie, Evangelische Kliniken Bonn, Bonn, Germany.

出版信息

Technol Health Care. 2016 Sep 14;24(5):647-53. doi: 10.3233/THC-161160.

Abstract

BACKGROUND

Radiofrequency ablation (RFA) temperatures reaching 45°C in adjacent tissues are cytotoxic to the spinal cord, nerves and surrounding tissues.

OBJECTIVE

This study compares different RFA electrodes with regard to the temperature distribution during ablation of spinal metastases.

METHODS

In vitro experimental study in isolated lumbar vertebrae of a human cadaveric spine. The temperature distribution of RFA electrodes was measured during ablation in human cadaveric lumbar vertebrae containing a simulated vertebral body lesion. The analysis compared a novel bipolar RFA electrode with two conventional monopolar RFA electrodes. A vertebral metastasis model was prepared in eight lumbar vertebrae for each electrode. Differences between the electrodes were evaluated with a one-way ANOVA.

RESULTS

The lowest temperature at the thermocouples adjacent to the simulated lesion was achieved when using the bipolar RFA electrode (46.4 ± 3.3°C), but temperature difference to the monopolar RFA electrodes was not significant. In the neural foramen and epidural space of lumbar vertebrae the maximal temperature measured when using the bipolar RFA electrode was 37.0 ± 0°C and 37.3 ± 0.7°C, which was significantly lower than during ablation via either of the monopolar RFA electrodes (p ≤ 0.001).

CONCLUSIONS

Temperatures in areas of adjacent tissue during RFA using a specific for spinal ablation designed electrode with integrated thermocouples were significantly lower compared to other electrodes, potentially reducing temperature related risks during ablation.

摘要

背景

射频消融(RFA)时,相邻组织温度达到45°C会对脊髓、神经及周围组织产生细胞毒性。

目的

本研究比较不同RFA电极在脊柱转移瘤消融过程中的温度分布情况。

方法

在人体尸体脊柱的离体腰椎上进行体外实验研究。在含有模拟椎体病变的人体尸体腰椎消融过程中,测量RFA电极的温度分布。分析比较一种新型双极RFA电极与两种传统单极RFA电极。为每个电极在八个腰椎上制备椎体转移瘤模型。电极之间的差异采用单因素方差分析进行评估。

结果

使用双极RFA电极时,模拟病变相邻热电偶处的温度最低(46.4±3.3°C),但与单极RFA电极的温度差异不显著。在腰椎神经孔和硬膜外间隙,使用双极RFA电极时测得的最高温度分别为37.0±0°C和37.3±0.7°C,显著低于使用任一单极RFA电极消融时的温度(p≤0.001)。

结论

与其他电极相比,使用带有集成热电偶的专门用于脊柱消融的电极进行RFA时,相邻组织区域的温度显著更低,可能会降低消融过程中与温度相关的风险。

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