The vascular cooling effect in hepatic multipolar radiofrequency ablation leads to incomplete ablation ex vivo
The vascular cooling effect in hepatic multipolar radiofrequency ablation leads to incomplete ablation ex vivo
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DOI：
10.1080/02656736.2016.1196395
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发表时间：
2016-01-01
影响因子：
3.1
通讯作者：
Lehmann, Kai S.
中科院分区：
文献类型：
--
作者：
Poch, Franz G. M.;Rieder, Christian;Lehmann, Kai S.
目的：传统RFA的主要局限性是血管冷却效应。然而，血管冷却效应在多极RFA中不太明显。本体外研究的目的是系统评价多极RFA.Materials和Methods中的血管冷却效应：在猪肝中进行离体多极RFA与三个双极RFA喷头（喷头距离20 mm，能量输入40 kJ）。将盐水灌注的玻璃管（“血管”）平行于施用器放置，以模拟天然肝脏血管。测试了5种施源器-血管几何形状。使用无灌注的液体填充玻璃管作为干运行。在规定的高度处，在施用器上垂直切割消融。冷却效果进行了定性和定量分析沿着这些横截面积。与干运行相比，在所有灌注血管消融中均观察到冷却效应。虽然这种冷却效应对消融面积没有任何影响（859-1072 mm（2）与空运行中的958 mm（2），p>0.05），但它对消融形状有明显影响。与空运行相比，在所有直接围绕血管灌注的消融术中均可观察到血管冷却效应，与施源器位置无关（p
Purpose: Major limitations of conventional RFA are vascular cooling effects. However, vascular cooling effects are supposed to be less pronounced in multipolar RFA. The objective of this ex vivo study was a systematic evaluation of the vascular cooling effects in multipolar RFA.Materials and methods: Multipolar RFA with three bipolar RFA applicators was performed ex vivo in porcine liver (applicator distance 20 mm, energy input 40 kJ). A saline-perfused glass tube ('vessel') was placed parallel to the applicators in order to simulate a natural liver vessel. Five applicator-to-vessel geometries were tested. A liquid-filled glass tube without perfusion was used as a dry run. Ablations were orthogonally cut to the applicators at a defined height. Cooling effects were analysed qualitatively and quantitatively along these cross sectional areas.Results: Thirty-six ablations were performed. A cooling effect could be seen in all ablations with per-fused vessels compared to the dry run. While this cooling effect did not have any influence on the ablation areas (859-1072 mm(2) versus 958 mm(2) in the dry run, p>0.05), it had a distinctive impact on ablation shape. A vascular cooling effect could be observed in all ablations with perfusion directly around the vessel independent of the applicator position compared to the dry run (p