小型猪肝脏局部碘化油微环境对微波消融灶的影响
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摘要
目的探讨小型猪肝组织碘化油微环境对相应区域微波消融灶形态和大小的影响。方法选取10只小型猪随机分为实验组和对照组,每组各5只,对实验组动物于经肝动脉碘化油肝叶栓塞后再行微波消融,对照组直接行常规微波消融。消融后即刻进行CT检查,测量消融灶最大长轴直径(LAD)和最大短轴直径(SAD),计算其球形指数(SI,SI=SAD/LAD)和体积,并比较两组间的差异。结果消融后,实验组LAD、SAD、SI及体积分别为(4.21±0.52)cm、(2.87±0.38)cm、0.69±0.10及(18.72±6.08)cm~3,对照组分别为(3.71±0.42)cm、(2.19±0.42)cm、0.60±0.09及(9.44±2.29)cm~3,2组间差异均有统计学意义(P均<0.05)。结论小型猪局部肝组织碘化油微环境可使该区域产生更大、更近似于球形的微波消融灶。
Objective To explore the impact of local lipiodol deposition in liver of miniature pigs on the shape and size of the necrotic area after microwave ablation(MWA).Methods Ten healthy miniature pigs were selected and equally divided into experimental group and control group(each n=5).In experimental group,transcatheter hepatic arterial embolization with lipiodol was done before microwave ablation,while only standard microwave ablation was performed in control group.Immediate post-ablation CT images were obtained.Long-axis diameter(LAD),short-axis diameter(SAD),sphericity index(SI=SAD/LAD)and volume of ablation zone were calculated.The size and shape of the ablated areas were compared between two groups.Results The mean LAD,SAD,SI and volume of ablation zone in experimental group([4.21±0.52]cm,[2.87±0.38]cm,0.69±0.10,[18.72±6.08]cm~3)were larger than those in control group([3.71±0.42]cm,[2.19±0.42]cm,0.60±0.09,[9.44±2.29]cm~3;all P<0.05).Conclusion Local deposition of lipiodol in liver parenchyma of miniature pigs can help to produce larger and rounder necrosis in the ablation zone.
Objective To explore the impact of local lipiodol deposition in liver of miniature pigs on the shape and size of the necrotic area after microwave ablation(MWA).Methods Ten healthy miniature pigs were selected and equally divided into experimental group and control group(each n=5).In experimental group,transcatheter hepatic arterial embolization with lipiodol was done before microwave ablation,while only standard microwave ablation was performed in control group.Immediate post-ablation CT images were obtained.Long-axis diameter(LAD),short-axis diameter(SAD),sphericity index(SI=SAD/LAD)and volume of ablation zone were calculated.The size and shape of the ablated areas were compared between two groups.Results The mean LAD,SAD,SI and volume of ablation zone in experimental group([4.21±0.52]cm,[2.87±0.38]cm,0.69±0.10,[18.72±6.08]cm~3)were larger than those in control group([3.71±0.42]cm,[2.19±0.42]cm,0.60±0.09,[9.44±2.29]cm~3;all P<0.05).Conclusion Local deposition of lipiodol in liver parenchyma of miniature pigs can help to produce larger and rounder necrosis in the ablation zone.
引文
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[2]Lee KF Wong J,Hui JW,et al.Long-term outcomes of microwave versus radiofrequency ablation for hepatocellular carcinoma by surgical approach:A retrospective comparative study.Asian J Surg,2017,40(4):301-308.
[3]Poulou LS.Percutaneous microwave ablation vs radiofrequency ablation in the treatment of hepatocellular carcinoma.World J Hepatol,2015,7(8):1054-1063.
[4]马文静,郭双双,张立成,等.肝动脉化疗栓塞联合微波消融治疗肝癌的临床研究.中国现代医药杂志,2012,14(5):28-30.
[5]疏云,王洪云,陶黎明,等.经肝动脉化疗栓塞联合微波消融治疗大肝癌的疗效观察.实用癌症杂志,2014,29(8):996-998.
[6]Liu C,Liang P,Liu F,et al.MWA Combined with TACE as a combined therapy for unresectable large-sized hepotocellular carcinoma.Int J Hyperthermia,2011,27(7):654-662.
[7]李梅,姚乐,程媛,等.肝动脉化疗栓塞联合微波消融治疗中晚期肝癌的疗效观察.现代肿瘤医学,2015,23(16):2351-2355.
[8]董健,陈奇峰,夏金国,等.TACE联合微波消融对比单独TACE治疗>5cm原发性肝癌的倾向性匹配分析.介入放射学杂志,2017,26(20):894-898.
[9]王健,宋莉,佟小强,等.肝动脉化疗栓塞联合射频消融治疗直径>5cm的原发性肝癌.中国微创外科杂志,2015,15(10):878-82.
[10]吕天石,邹英华,王健,等.经肝动脉化疗栓塞术联合射频消融治疗原发性肝癌的现状.临床肝胆病杂志,2016,32(1):49-55.
[11]Irie K,Morimoto M,Numata K,et al.Enhancement of radiofrequency ablation of the liver combined with transarterial embolization using various embolic agents.Abdom Imaging,2014,40(6):1821-1828.
[12]宋莉,佟小强,王健,等.碘化油肝动脉栓塞对灌注型射频消融的影响:实验研究.中国介入影像与治疗学,2010,(27):181-184.
[13]Dodd GD 3rd,Kreidler SM,Lanctot AC,et al.Effect of change in portal venous blood flow rates on the performance of a 2.45-GHz microwave ablation device.Radiology,2015,277(3):727-732.
[14]Dodd GD 3rd,Dodd NA,Lanctot AC,et al.Effect of variation of portal venous blood flow on radiofrequency and microwave ablations in a blood-perfused bovine liver model.Radiology,2013,267(1):129-136.
[15]Ringe KI,Lutat C,Rieder C,et al.Experimental evaluation of the heat sink effect in hepatic microwave ablation.PLoS One,2015,10(7):e0134301.
[16]Deshazer G,Merck D,Hagmann M,et al.Physical modeling of microwave ablation zone clinical margin variance.Med Phys,2016,43(4):1764.
[17]Fan W,Li X,Zhang L,et al.Comparison of microwave ablation and multipolar radiofrequency ablation in vivo using two internally cooled probes.AJR Am J Roentgenol,2012,198(1):W46-W50.
[18]Bhardwaj N,Dormer J,Ahmad F,et al.Microwave ablation of the liver:A description of lesion evolution over time and an investigation of the heat sink effect.Pathology,2011,43(7):725-731.
[19]Yu J,Liang P,Yu X,et al.A comparison of microwave ablation and bipolar radiofrequency ablation both with an internally cooled probe:Results in ex vivo and in vivo porcine livers.Eur J Radiol,2011,79(1):124-130.
[20]Guang C,Kawai N,Sato M,et al.Effect of interval between transcatheter hepatic arterial embolization and radiofrequency ablation on ablated lesion size in a swine model.Jpn J Radiol,2011,29(9):649-655.