Department of Radiology, University Hospital Regensburg, Regensburg, Germany.
Department of Radiology and Nuclear Medicine, Hospital Braunschweig, Braunschweig, Germany.
PLoS One. 2020 Nov 17;15(11):e0242093. doi: 10.1371/journal.pone.0242093. eCollection 2020.
To evaluate the appearance and size of ablation zones in gadoxetic-acid-enhanced magnetic resonance imaging (MRI) during the first year after irreversible electroporation (IRE) of primary or secondary hepatic malignancies and to investigate potential correlations to clinical features.
The MRI-appearance of the ablation area was assessed 1-3 days, 6 weeks, 3 months, 6 months, 9 months and 1 year after IRE. The size of the ablation zone and signal intensities of each follow-up control were compared. Moreover, relationships between clinical features and the MRI-appearance of the ablation area 1-3 days after IRE were analyzed.
The ablation zone size decreased from 5.6 ± 1.4 cm (1-3 days) to 3.7±1.2 cm (1 year). A significant decrease of central hypointensities was observed in T2-blade- (3 months), T2 haste- (6 weeks; 3 months; 6 months; 1 year), T1 arterial phase- (3 months; 1 year), and diffusion-sequences (6 weeks; 3 months; 6 months; 9 months; 1 year). The unenhanced T1-sequences showed significantly increasing central hypointensities (6 weeks; 3 months; 6 months; 9 months; 1 year). Significantly increasing peripheral hypointensities were detected in T1 arterial phase- (3 months; 6 months; 9 months; 1 year) and in T1 portal venous phase-sequences (6 weeks; 3 months; 6 months; 9 months; 1 year). Peripheral hypointensities of unenhanced T1-sequences decreased significantly 1 year after IRE. 1-3 days after IRE central T1 portal venous hypo- or isointensities were detected significantly more often than hyperintensities, if more than 3 IRE electrodes were used.
Hepatic IRE results in continuous reduction of ablation zone size during the first postinterventional year. In addition to centrally decreasing T1-signal and almost steadily increasing signal in the enhanced T2 haste-, diffusion- and T1 arterial phase-sequences, there is a trend toward long-term decreasing T1 arterial- and portal venous MRI-signal intensity of the peripheral ablation area, probably representing a region of reversible electroporation.
在原发性或继发性肝恶性肿瘤不可逆电穿孔（IRE）后 1 年内，评估钆塞酸增强磁共振成像（MRI）中消融区的外观和大小，并探讨其与临床特征的潜在相关性。
IRE 后 1-3 天、6 周、3 个月、6 个月、9 个月和 1 年，评估消融区的 MRI 外观。比较每个随访控制的消融区大小和信号强度。此外，分析了 IRE 后 1-3 天与消融区 MRI 外观相关的临床特征。
消融区大小从 5.6±1.4cm（1-3 天）减少到 3.7±1.2cm（1 年）。在 T2 叶片（3 个月）、T2 haste（6 周；3 个月；6 个月；1 年）、T1 动脉期（3 个月；1 年）和弥散序列（6 周；3 个月；6 个月；9 个月；1 年）中观察到中央低信号显著减少。未增强 T1 序列显示中央低信号显著增加（6 周；3 个月；6 个月；9 个月；1 年）。在 T1 动脉期（3 个月；6 个月；9 个月；1 年）和 T1 门静脉期序列（6 周；3 个月；6 个月；9 个月；1 年）中检测到明显增加的外周低信号。IRE 后 1 年，未增强 T1 序列的外周低信号显著减少。IRE 后 1-3 天，如果使用超过 3 个 IRE 电极，则检测到中央 T1 门静脉低信号或等信号明显多于高信号。
在首次介入后 1 年内，IRE 导致消融区大小持续减少。除了中央 T1 信号逐渐降低，增强 T2 haste、弥散和 T1 动脉期序列中的信号几乎稳定增加外，外周消融区 T1 动脉期和门静脉 MRI 信号强度也呈长期下降趋势，可能代表可逆电穿孔区域。
