Imajo Kento, Ogawa Yuji, Yoneda Masato, Saito Satoru, Nakajima Atsushi
Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan.
J Med Ultrason (2001). 2020 Apr;47(2):265-277. doi: 10.1007/s10396-019-00997-5. Epub 2020 Jan 20.
Although microwave ablation (MWA) exhibits a high thermal efficiency, the major limitation of conventional MWA systems is the lack of predictability of the ablation zone size and shape. Therefore, a specific newer generation MWA system, The Emprint™ Ablation System with Thermosphere™ Technology, was designed to create predictable large spherical zones of ablation that are not impacted by varying tissue environments. The time required for ablation with MWA systems is short, and the shape of the necrosis is elliptical with the older systems and spherical with the new system. In addition, because MWA has no heat-sink effect, it can be used to ablate tumors adjacent to major vessels. Although these factors yield a large ablation volume and result in good local control, excessive ablation of liver tissue and unexpected ablation of surrounding organs are possible. Therefore, MWA should be carefully performed. This review highlights the efficacy and complications of MWA performed with conventional systems and the newer generation system in patients with hepatocellular carcinoma (HCC). MWA with the newer generation system seems to be a promising treatment option for large HCCs and secondary hepatic malignancies, with several advantages over other available ablation techniques, including conventional MWA. However, further randomized controlled trials are necessary to fully clarify the benefits and pitfalls of this new system.
尽管微波消融（MWA）具有较高的热效率，但传统MWA系统的主要局限性在于消融区大小和形状缺乏可预测性。因此，一种特定的新一代MWA系统，即采用热球技术的Emprint™消融系统，旨在创建可预测的大球形消融区，且不受不同组织环境的影响。MWA系统进行消融所需时间较短，在旧系统中坏死形状为椭圆形，而在新系统中为球形。此外，由于MWA没有热沉效应，它可用于消融靠近大血管的肿瘤。尽管这些因素可产生较大的消融体积并实现良好的局部控制，但仍有可能过度消融肝组织以及意外消融周围器官。因此，应谨慎进行MWA。本综述重点介绍了在肝细胞癌（HCC）患者中使用传统系统和新一代系统进行MWA的疗效和并发症。新一代系统的MWA似乎是大型HCC和继发性肝恶性肿瘤的一种有前景的治疗选择，与其他可用的消融技术（包括传统MWA）相比具有多个优势。然而，需要进一步的随机对照试验来充分阐明这种新系统的益处和缺陷。
