Electric Ablation with Irreversible Electroporation (IRE) in Vital Hepatic Structures and Follow-up Investigation.
Electric Ablation with Irreversible Electroporation (IRE) in Vital Hepatic Structures and Follow-up Investigation.
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重要肝脏结构的不可逆电穿孔 (IRE) 电消融及后续研究
DOI：
10.1038/srep16233
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发表时间：
2015-11-09
影响因子：
4.6
通讯作者：
Zheng S
中科院分区：
文献类型：
--
作者：
Chen X;Ren Z;Zhu T;Zhang X;Peng Z;Xie H;Zhou L;Yin S;Sun J;Zheng S
不可逆电穿孔（IRE）与微秒脉冲电场（μsPEF）可以有效消融动物模型中的肝细胞癌。这项临床前研究评估了 IRE 对猪肝脏的可行性和安全性。总共包括10头猪。使用计算机断层扫描 (CT) 引导插入肝门和胆囊附近的两针电极。在治疗后2小时以及2、7和14天对动物进行随访。 μsPEF消融期间和消融后，心电图未发现心血管事件，对比CT未发现门静脉血栓形成。消融区出现坏死。治疗后2小时发现胆囊周围轻度囊性水肿。病理学研究显示广泛的细胞死亡。没有大血管损伤，但一些小血管有轻度内皮损伤。后续肝功能检查和血常规检查显示肝功能立即受损和恢复，这与病理变化相关。这些结果表明，μsPEF消融影响肝组织，但对血管的效果较差，这使得μsPEF能够消融接近肝门、大血管和胆管附近的中心肿瘤病灶，消除了常规热消融的一些局限性和禁忌症。
Irreversible electroporation (IRE) with microsecond-pulsed electric fields (μsPEFs) can effectively ablate hepatocellular carcinomas in animal models. This preclinical study evaluates the feasibility and safety of IRE on porcine livers. Altogether, 10 pigs were included. Computed tomography (CT) was used to guide two-needle electrodes that were inserted near the hilus hepatis and gall bladder. Animals were followed-up at 2 hours and at 2, 7 and 14 days post-treatment. During and after μsPEF ablation, electrocardiographs found no cardiovascular events, and contrast CT found no portal vein thrombosis. There was necrosis in the ablation zone. Mild cystic oedema around the gall bladder was found 2 hours post-treatment. Pathological studies showed extensive cell death. There was no large vessel damage, but there was mild endothelial damage in some small vessels. Follow-up liver function tests and routine blood tests showed immediate liver function damage and recovery from the damage, which correlated to the pathological changes. These results indicate that μsPEF ablation affects liver tissue and is less effective in vessels, which enable μsPEFs to ablate central tumour lesions close to the hilus hepatis and near large vessels and bile ducts, removing some of the limitations and contraindications of conventional thermal ablation.