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基于 CT 的活体猪肝模型中微波消融后短期组织收缩的定量研究。

CT-based quantification of short-term tissue shrinkage following hepatic microwave ablation in an in vivo porcine liver model.

机构信息

Charité - Universitätsmedizin Berlin, Department of Radiology, Berlin, Germany.

Charité - Universitätsmedizin Berlin, Department of Surgery, Berlin, Germany.

出版信息

Acta Radiol. 2021 Jan;62(1):12-18. doi: 10.1177/0284185120914452. Epub 2020 Apr 7.

Abstract

BACKGROUND

Microwave ablation (MWA) is a minimally invasive treatment option for solid tumors and belongs to the local ablative therapeutic techniques, based on thermal tissue coagulation. So far there are mainly ex vivo studies that describe tissue shrinkage during MWA.

PURPOSE

To characterize short-term volume changes of the ablated zone following hepatic MWA in an in vivo porcine liver model using contrast-enhanced computer tomography (CECT).

MATERIAL AND METHODS

We performed multiple hepatic MWA with constant energy parameters in healthy, narcotized and laparotomized domestic pigs. The volumes of the ablated areas were calculated from venous phase CT scans, immediately after the ablation and in short-term courses of up to 2 h after MWA.

RESULTS

In total, 19 thermally ablated areas in 10 porcine livers could be analyzed (n = 6 with two volume measurements during the measurement period and n = 13 with three measurements). Both groups showed a statistically significant but heterogeneous volume reduction of up to 12% (median 6%) of the ablated zones in CECT scans during the measurement period ( < 0.001 [n = 13] and  = 0.042 [n = 6]). However, the dimension and dynamics of volume changes were heterogenous both absolutely and relatively.

CONCLUSION

We observed a significant short-term volume reduction of ablated liver tissue in vivo. This volume shrinkage must be considered in clinical practice for technically successful tumor treatment by MWA and therefore it should be further investigated in in vivo studies.

摘要

背景

微波消融(MWA)是一种针对实体肿瘤的微创治疗选择,属于基于热组织凝固的局部消融治疗技术。到目前为止,主要有体外研究描述了 MWA 过程中的组织收缩。

目的

使用对比增强计算机断层扫描(CECT)在活体猪肝脏模型中描述肝 MWA 后消融区的短期体积变化。

材料与方法

我们在健康、麻醉和剖腹的家猪中进行了多次 MWA,能量参数保持不变。在 MWA 后立即以及在短时间内(最长 2 小时)进行静脉期 CT 扫描,计算消融区域的体积。

结果

总共对 10 个猪肝中的 19 个热消融区域进行了分析(n=6 在测量期间进行了两次体积测量,n=13 进行了三次测量)。两组均显示 CECT 扫描中消融区域的体积显著但不均匀减少,在测量期间分别为 6%(中位数)( < 0.001[n=13]和 0.042[n=6])。然而,体积变化的大小和动态在绝对值和相对值上均存在异质性。

结论

我们观察到活体消融肝组织的短期体积显著减少。在 MWA 技术上成功治疗肿瘤的临床实践中必须考虑到这种体积收缩,因此应在体内研究中进一步研究。

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