消融针与血管距离对离体猪肝脏模拟血管旁微波消融范围及效果的影响  

Impact of distance between ablation needle and blood vessel on the zone and efficacy of microwave ablation adjacent to simulated vessels in ex vivo porcine liver

作　　者：杨鑫[1] 罗霞 何萍 张菊英 蒋琼 冯琳莉 李韩梅 唐小清 杨友 余进洪[1] YANG Xin;LUO Xia;HEPing;ZHANG Juying;JIANG Qiong;FENG Linli;LI Hanmei;TANG Xiaoqing;YANG You;YU Jinhong(Department of Ultrasound,Affiliated Hospital of North Sichuan Medical College,Nanchong,Sichuan 637000,China)

机构地区：[1]川北医学院附属医院超声科,四川南充637000

出　　处：《中华实用诊断与治疗杂志》2025年第3期225-230,共6页Journal of Chinese Practical Diagnosis and Therapy

摘　　要：目的 建立离体猪肝脏的不同直径模拟血管模型,探讨消融针与血管距离对微波消融灶范围及消融效果的影响。方法 取90块新鲜离体猪肝脏,分为4、6、8 mm模拟血管组各30块,沿猪肝脏门静脉分别插入内径为4、6、8 mm的PP塑料管,PP塑料管连接恒流泵,以生理盐水模拟血液,以人体门静脉流速[(20±2)cm/s]模拟血液流速。4、6、8 mm模拟血管组各取6块猪肝脏,分别于距模拟血管0.5 cm(A点)、1.0 cm(B点)、1.5 cm(C点)、2.0 cm(D点)、2.5 cm(E点)处,在超声引导下将消融针平行于PP塑料管插入猪肝组织,以60 W功率消融7 min。另取6块新鲜离体猪肝脏为对照组,不建立模拟血管,超声引导下将消融针避开较大血管结构插入肝组织,以60 W功率消融7 min。微波消融结束后,垂直消融针方向剖开猪肝脏,取消融灶最大横截面,应用软件测量消融灶最大半径(R_(max)),并计算面积(S)及面积变化率(S_(diff))。比较3个模拟血管组A、B、C、D、E点处消融灶与对照组消融灶的R_(max)及S,比较3个模拟血管组A、B、C、D、E点处消融灶的R_(max)、S及S_(diff)。结果 (1)4、6、8 mm模拟血管组消融灶R_(max)、S在A[R_(max):(1.04±0.03)cm、(1.03±0.04)cm、(1.02±0.04)cm;S:(2.20±0.17)cm^(2)、(2.08±0.17)cm^(2)、(2.05±0.17)cm^(2)]、B[R_(max):(1.14±0.02)cm、(1.13±0.02)cm、(1.11±0.03)cm;S:(3.26±0.23)cm^(2)、(3.04±0.21)cm^(2)、(2.99±0.17)cm^(2)]、C[R_(max):(1.20±0.02)cm、(1.19±0.01)cm、(1.17±0.02)cm;S:(4.05±0.20)cm^(2)、(3.88±0.20)cm^(2)、(3.75±0.14)cm^(2)]点处均小于对照组[R_(max):(1.22±0.02)cm, S:(4.60±0.18)cm^(2)](t=2.268~25.790P均<0.05),在D、E点处与对照组比较差异均无统计学意义(P>0.05)。(2)4、6、8 mm模拟血管组A、B、C、D、E点处消融灶R_(max)、S、S_(diff)比较差异均有统计学意义(F=59.270~142.444、F=61.865~155.203、F=54.883~198.547,P均<0.001)。4、6、8 mm模拟血管组A、B、C点处消融灶R_(max)、S均依次增大(P<0.05),S_(diffObjective To construct ex vivo porcine liver models with simulated vessels of varying diameters,and to investigate the influence of the distance between ablation needle and blood vessel on the microwave ablation zone and efficacy.Methods Ninety pieces of fresh porcine liver were collected and were inserted respectively with PP plastic tubes 4,6 and 8 mm in diameter along the portal vein(the 4-,6-and 8-mm simulated vessel groups,with 30 pieces of liver in each group).The tube was connected to a constant flow pump and the blood was simulated with normal saline at a blood flow velocity of(20±2)cm/s(human portal vein flow velocity).Six pieces of liver were selected from each group.Under ultrasound guidance,an ablation needle was inserted parallel to the PP plastic tube into the liver tissue at distances of 0.5 cm(point A),1.0 cm(point B),1.5 cm(point C),2.0 cm(point D),and 2.5 cm(point E)from the simulated vessel,with an ablation power of 60 W for 7 min.Another six pieces of fresh ex vivo porcine liver were used as the control group,without establishing simulated vessels.Under ultrasound guidance,the ablation needle was inserted into the liver tissue while avoiding larger vascular structures,with an ablation power of 60 W for 7 min.Following microwave ablation,the liver was sectioned perpendicular to the ablation needle,and the maximum cross-section of the ablation zone was obtained.Using software,the maximum radius(R_(max))of the ablation zone was measured,and the area(S)and area change rate(S_(diff))were calculated.The R_(max) and S of ablation zones at point A to E in the three groups were compared with those of the control group.Additionally,R_(max),S and S_(diff) at point A to E were analyzed across the three groups.Results(1)In the 4-,6-and 8-mm simulated vessel groups,the R_(max) and S were smaller at point A[R_(max):(1.04±0.03),(1.03±0.04),(1.02±0.04)cm;S:(2.20±0.17),(2.08±0.17),(2.05±0.17)cm^(2)],B[R_(max):(1.14±0.02),(1.13±0.02),(1.11±0.03)cm;S:(3.26±0.23),(3.04±0.21),(2.99±0.17)cm^(2)],and C[R

关 键 词：微波消融 热沉降效应 消融范围 新鲜猪肝脏 

分 类 号：R735.7[医药卫生—肿瘤]