Comparison of wet radiofrequency ablation with dry radiofrequency ablation and radiofrequency ablation using hypertonic saline preinjection: ex vivo bovine liver.
Comparison of wet radiofrequency ablation with dry radiofrequency ablation and radiofrequency ablation using hypertonic saline preinjection: ex vivo bovine liver.
复制标题
DOI：
10.3348/kjr.2004.5.4.258
复制
发表时间：
2004-10
影响因子：
4.8
通讯作者：
Choi BI
中科院分区：
文献类型：
--
作者：
Lee JM;Han JK;Kim SH;Shin KS;Lee JY;Park HS;Hur H;Choi BI
我们希望比较湿射频（RF）消融的体外效率与干RF消融和使用离体牛肝预注射NaCl溶液的RF消融的效率。使用200 W发生器和灌注冷却电极，在单极模式下对切除的牛肝脏进行放射性治疗，持续10分钟，有或没有注射或缓慢输注NaCl溶液。将灌注冷却的电极置入切除的肝脏后，用5种不同的方法建立50个消融区：A组，标准干式射频消融组（B），射频消融前注射11 mL 5% NaCl溶液组（C组），射频消融后以1 mL/min的速率注入11 mL 5% NaCl溶液组（D组），射频消融后以1 mL/min的速率注入11 mL 5% NaCl溶液组（C组）。E组射频消融前注射36%NaCl溶液6 mL，C、E组射频消融前1 min开始输注36%NaCl溶液6 mL，输注速率为0.5 mL/min，在射频消融过程中持续输注（湿消融）。在射频消融过程中，我们测量了距离电极15 mm处的组织温度。然后比较两组之间消融区的尺寸以及射频消融期间阻抗、电流和肝脏温度的变化。通过注射或输注NaCl溶液，射频消融前B、C、D和E组的平均初始组织阻抗（43-75 Ω）显著低于A组（80 Ω）（p < 0.05）。在射频消融过程中，C组和E组的组织阻抗控制良好，但A组和B组的组织阻抗经常迅速增加到200 Ω以上。在D组中，10次试验中有6次阻抗控制良好，但在开始射频消融后7 min，有4次试验（40%）阻抗增加。结果，C、D和E组的平均电流高于其他组：A组为401 ± 145 mA，B组为287 ± 32 mA，C组为1907 ± 96 mA，D组为1649 ± 514 mA，E组为1968 ± 108 mA（p < 0.05）。C、E组凝固性坏死体积大于D组，A、B组大于E组（p < 0.05）; A组14.3 ± 3.0 cm 3; B组12.4 ± 3.8 cm 3; C组80.9 ± 9.9 cm 3; D组45.3 ± 11.3 cm 3; E组81.6 ± 8.6 cm 3。C、D和E组在距离电极15 mm处测量的组织温度高于其他组（p < 0.05）：A组为53 ± 12℃，B组为42 ± 2℃，C组为93 ± 8℃; D组为79 ± 12℃，E组为83 ± 8℃。使用5%或36%NaCl溶液的湿射频消融在创建大消融区方面显示出比干射频消融或预注射NaCl溶液的射频消融更好的效率。
We wished to compare the in-vitro efficiency of wet radiofrequency (RF) ablation with the efficiency of dry RF ablation and RF ablation with preinjection of NaCl solutions using excised bovine liver. Radiofrequency was applied to excised bovine livers in a monopolar mode for 10 minutes using a 200 W generator and a perfused-cooled electrode with or without injection or slow infusion of NaCl solutions. After placing the perfused-cooled electrode in the explanted liver, 50 ablation zones were created with five different regimens: group A; standard dry RF ablation, group B; RF ablation with 11 mL of 5% NaCl solution preinjection, group C; RF ablation with infusion of 11 mL of 5% NaCl solution at a rate of 1 mL/min, group D; RFA with 6 mL of 36% NaCl solution preinjection, group E; RF ablation with infusion of 6 mL of 36% NaCl solution at a rate of 0.5 mL/min. In groups C and E, infusion of the NaCl solutions was started 1 min before RF ablation and then maintained during RF ablation (wet RF ablation). During RF ablation, we measured the tissue temperature at 15 mm from the electrode. The dimensions of the ablation zones and changes in impedance, current and liver temperature during RF ablation were then compared between the groups. With injection or infusion of NaCl solutions, the mean initial tissue impedance prior to RF ablation was significantly less in groups B, C, D, and E (43-75 Ω) than for group A (80 Ω) (p < 0.05). During RF ablation, the tissue impedance was well controlled in groups C and E, but it was often rapidly increased to more than 200 Ω in groups A and B. In group D, the impedance was well controlled in six of ten trials but it was increased in four trials (40%) 7 min after starting RF ablation. As consequences, the mean current was higher for groups C, D, and E than for the other groups: 401 ± 145 mA in group A, 287 ± 32 mA in group B, 1907 ± 96 mA in group C, 1649 ± 514 mA in group D, and 1968 ± 108 mA in group E (p < 0.05). In addition, the volumes of RF-induced coagulation necrosis were greater in groups C and E than in group D, which was greater than in groups A and B than in group E (p < 0.05); 14.3 ± 3.0 cm3 in group A; 12.4 ± 3.8 cm3 in group B; 80.9 ± 9.9 cm3 in group C; 45.3 ± 11.3 cm3 in group D and 81.6 ± 8.6 cm3 in group E. The tissue temperature measured at 15 mm from the electrode was higher in groups C, D and E than other groups (p < 0.05): 53 ± 12℃ in group A, 42 ± 2℃ in group B, 93 ± 8℃ in group C; 79 ± 12℃ in group D and 83 ± 8℃ in group E. Wet RF ablation with 5% or 36% NaCl solutions shows better efficiency in creating a large ablation zone than does dry RF ablation or RF ablation with preinjection of NaCl solutions.