超声引导扇形立体定位单极冷循环射频消融离体猪肝实验研究  

Ultrasound-guided Multipoint Sector Stereotaxis in Unipolar Cooling Cycle Radiofrequency Ablation Treatment of Isolated Pork Livers

作　　者：李丹丹[1] 黄进[1] 李文伦[1] 侯智文[1] 孔庆锋[1] 

机构地区：[1]潍坊医学院附属潍坊市人民医院超声科,山东省潍坊市261041

出　　处：《中国超声医学杂志》2011年第5期392-395,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的通过离体猪肝的实验研究为超声引导扇形立体定位单极冷循射频消融(RFA)治疗肝癌提供参考依据。方法应用单极冷循环射频消融治疗仪,取新鲜离体猪肝20个,分成2组,每组10个,应用单点和多点2种方法进行实验。单点每次消融时间分别设定为6、8、10、12 min;多点扇形立体定位按设计为1针2点、2针4点、3针6点、4针8点法,每次消融时间设定为6 min。电极间的间距为2 cm。发射功率分别设置为50、70、90、120 W,在超声引导下行穿刺新鲜猪肝进行射频消融,超声实时观察猪肝声像图变化。切开猪肝观察及测量凝固范围,计算消融凝固面积,并将两组消融的面积进行比较;同时行病理检查。结果声像图显示强回声气化区域逐渐扩大,离体猪肝凝固性坏死面积随时间及功率的增加逐渐扩大,扩大到一定范围后不再扩大。切开猪肝观察,单点消融区域的形态呈椭球形;多点扇形立体定位离体猪肝消融区域的形态呈类圆形,消融范围明显大于单点消融。镜下:RFA治疗区周围1 cm肝细胞正常,作用区细胞脱落、松解、变性,大片坏死区,失去小叶结构。结论多点扇形立体定位消融范围明显大于单点消融,能够达到预期的治疗目的 ,估计具有一定临床实用价值。Objective To investigate hepatocellubr carcinoma therapy by uitrasouncl-guloea multipoint stereotaxis in unipolar cooling cycle radiofrequency ablation treatment（RFA） with isolated pork livers. Methods 20 pork livers were randomly separated into two groups, single-point method and multipoint sector stereotaxis method were carried out in the experiment. The ablating time was set to 6,8, 10, 12 minutes respectively in single-point group. In multipoint sector stereotaxis group, 1 needle 2 points,2 needles 4 points,3 needles 6 points and 4 needles 8 points were adopted, the ablating time was set to 6 minutes each time, the distance between the electrodes was 2 cm, the transmit power was 50, 70, 90, 120W respectively, the fresh pork livers were punctured to perform the radiofrequency ablation gu＇ded by ultrasound. The solidificaton area was calculated, and the area of ablation of two groups was compared. The specimen was sent for pathology. Results Strong echo gasification area was gradually expanding. The coagulative necrosis area of isolated pork liver increased with time and power, but no longer expanded when reached to a certain degree. The incised liver showed the shape of the single-point ablation was spheroid, and the shape of multi- point sector stereotaxis ablation was round. The ablating range of multipoint sector stereotaxis ablation was significantly greater than that of the single-point ablation. Under the microscope： the liver cells around 1 cm outside the treatment region of RFA were normal. The cells in the active region fell out, degenerated, became necrotic in large area, and lost lobular structures. Conclusions The experiment of isolated pork livers showed that. The range of multi- point Sector Stereotaxis ablation is significantly greater than that of single-point, the multipoint ablation can achieve the expected therapeutic purposes and has certain clinical practical value.

关 键 词：射频消融 离体猪肝 凝固性坏死 超声引导 

分 类 号：R445.1[医药卫生—影像医学与核医学] R735.7[医药卫生—诊断学]