活体猪肢体长骨多极射频消融灶影像与病理改变对照研究  

Multi- polar radiofrequency ablation of pig's long bones in vivo: comparison study between imaging and pathology

作　　者：陈锦州 赵卫[2] 黄建强[2] 胡继红[2] 钱忠义[3] 

机构地区：[1]河南平顶山平煤神马医疗集团总医院介入放射科,467000 [2]昆明医科大学第一临床医学院影像中心介入放射科 [3]昆明医学院病理教研室

出　　处：《介入放射学杂志》2014年第4期325-328,共4页Journal of Interventional Radiology

摘　　要：目的通过对活体猪胫骨行经皮多极射频消融(radiofrequency ablation,RFA),观察骨端及骨干多极RFA灶的病理及影像改变,探讨与影像改变对应的病理组织学变化。方法麻醉状态下,于8只实验活体猪胫骨骨端、骨干的相同位置行多极RFA,于术后按实验设定时间处死实验动物,获取骨端、骨干标本,并在此过程中进行活体动物RFA部位X线、CT检查,肉眼观察标本及测量后行骨切片、HE染色,镜下观察。结果 X线及CT检查示骨端多极RFA灶早期无明显影像学改变;随后边缘出现低密度带,为肉芽组织吸收坏死骨质至骨密度减低所致,并向中部逐渐扩展;随后在低密度区外缘见骨质硬化带,为肉芽组织成熟形成的纤维组织内新骨形成所致,并向内缓慢填充。骨干多极RFA灶影像及病理改变大致与骨端相同,但易合并骨干病理性骨折及死骨形成。结论多极RFA灶X线及CT影像改变能反映其病理组织学变化,可作为骨肿瘤RFA灶的有效随访手段。Objective To observe the pathologic and imaging changes of pig’s diaphysis and epiphysis caused by multi-polar radiofrequency ablation （RFA）, and to discuss the relationship between the imaging findings and pathologic changes. Methods Under general anesthesia, RFA was carried out on the upper epiphysis and diaphysis of experimental pig’s tibias. Different operation time was used for RFA according to the experiment scheme, and then the pigs were executed by over anesthesia in order to gain the specimen of the upper epiphysis and diaphysis of the experimental pigs’ tibias. X-ray and CT examination were performed before the experimental pigs were sacrificed. The specimens thus collected were sent for pathological examination, both macroscopically and microscopically. HE dyeing was used. Results X-ray and CT scanning showed that at early stage there was no obvious imaging changes in RFA lesions. Then, low-density zone appeared at the edge of the lesions, which was due to the absorption of the necrotic bone by granulation tissue. Shortly after that, a zone of bone sclerosis emerged around the low-density area, which was due to the new bone formation within the fibrous tissue that was produced by the mature granulation tissue, and the bone tissue slowly filled the lesion. The pathologic and imaging changes of ablated diaphysis were quite the same as those of the epiphysis, but the pathological fracture of epiphysis and the formation of necrotic bone occurred more easily. Conclusion X-ray and CT scanning can reflect the pathologic changes of the ablated lesions created by multi-polar radiofrequency. Therefore, imaging examination can be used as an effective follow- up means for checking the RFA lesions of bone tumor. （J Intervent Radiol, 2014, 23：325-328）.

关 键 词：肢体长骨 多极射频消融 活体动物 影像学 病理学 

分 类 号：R738.1[医药卫生—肿瘤]