不可逆电穿孔与射频消融后猪肝脏再生的比较  

Liver regeneration after radiofrequency ablation versus irreversible electroporation

作　　者：黎升[1] 曾奇[1] 钟锐[1] 毛思月 沈露俊[1] 吴沛宏[1] 

机构地区：[1]华南肿瘤学国家重点实验室中山大学肿瘤防治中心影像与微创介入中心,广州510060

出　　处：《中华医学杂志》2015年第1期66-68,共3页National Medical Journal of China

摘　　要：目的 比较不可逆电穿孔（IRE）与射频消融后肝脏的再生情况.方法 10只实验小猪均分为IRE和射频两组.CT引导下对小猪肝脏行IRE或射频消融,每只动物肝脏消融2处.比较两种消融的细胞死亡、再生及恢复时间.定期行超声、CT、MRI和病理检查.结果 消融后即刻,影像学显示两组消融灶体积相近.IRE消融后3d,见肝细胞凋亡,肝小叶内红细胞增多,纤维结构完整,成纤维细胞增生.IRE消融后3周,消融灶消失或显著缩小,与周围正常肝脏分界不清,无纤维包膜形成.射频消融后3周,消融区无明显缩小,纤维包膜形成,与正常肝脏分界清楚.结论 IRE消融后肝脏再生较快,基质结构保存较好.Objective To compare liver regeneration after radiofrequency ablation versus irreversible electroporation （IRE）.Methods A total of 10 pigs were divided into IRE and radiofrequency ablation groups.And two ablation foci were established in the liver of each pig.Computed tomography （CT）-guided IRE and radiofrequency ablation were performed.Cell death,liver regeneration and recovery speed were compared.Before ablation,immediately,1 and 3 weeks after ablation,contrast enhanced ultrasound,CT and magnetic resonance imaging （MRI） were regularly performed.Immediately after ablation,24 hours,3 days,3 weeks and 6 weeks,biopsy and pathologic examination were performed.Results At 1-3 days after IRE ablation,apoptotic cells were detected in the ablation zone and numerous red blood cells were present in hepatic cords.Three days after IRE,fibroblasts were found.Three weeks after,most ablation lesions disappeared or significantly reduced.There was no formation of fibrous capsule.And indistinct boundary existed between the surrounding liver tissue and lesion.Immediately after ablation,coagulative necrosis of ablation zone in liver was confirmed.After 3 weeks,all lesions persisted in the radiofrequency ablation group.There was formation of fibrous capsule.Immediately after ablation,the ablation volume was similar between two groups on CT scan.Three weeks later,6 ablation foci in IRE group disappeared while another 4 lesions shrank more than 50％.There was no significant volume reduction in the radiofrequency ablation group.Conclusion Compared with radiofrequency ablation,IRE resulted in faster liver regeneration and intact extracellular structure.

关 键 词：消融技术 电穿孔 肝再生 

分 类 号：R339.37[医药卫生—人体生理学]