Percutaneous radiofrequency thermal ablation with hypertonic saline injection:: In vivo study in a rabbit liver model

被引:38
|
作者
Lee, JM
Kim, YK
Lee, YH
Kim, SW
Li, CA
Kim, CS
机构
[1] Seoul Natl Univ, Coll Med, Dept Radiol, Seoul, South Korea
[2] Chonbuk Natl Univ, Sch Med, Dept Radiol, Chonju, South Korea
[3] Wonkwang Univ Hosp, Dept Radiol, Iksan, South Korea
关键词
experimental study; liver; interventional procedures; radiofrequency ablation;
D O I
10.3348/kjr.2003.4.1.27
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Objective: To determine whether hypertonic saline (HS, 36% NaCl) injection prior to or during radiofrequency ablation (RFA) can increase the extent of thermally mediated coagulation in in-vivo rabbit liver tissue, and also to establish the ideal injection time in relation to RFA in order to maximize its effect on the extent of radiofrequency (RF)-induced coagulation. Materials and Methods: In 26 rabbits, 43 RFA lesions were produced using a 17-gauge internally cooled electrode with a 1-cm active tip under ultrasound (US) guidance. Rabbits were assigned to one of three groups: Group A: RFA alone (n=8); Group B: RFA after the instillation of 1 mL HS (n=8); Group C: RFA after and during the instillation of 0.5 mL HS (n=10). RF energy (30 W) was applied for 3 minutes, and. changes occurring in tissue impedance, current, power output, and the temperature of the electrode tip were automatically measured. After RFA, contrast-enhanced spiral CT was performed, and in each group the maximum diameters of the thermal lesions in gross specimens were compared. Technical success and the complications arising were evaluated by CT and on the basis of autopsy findings. Results: All procedures were technically successful. There were six procedure-related complications (6/26; 23%), including five localized perihepatic hematomas and one thermal injury to the stomach. With instillation of HS in group B rabbits, markedly decreased tissue impedance (73 Omega +/- 5) and increased current (704 mA +/- 41) were noted, compared to RF ablation without saline infusion (116.3 Omega +/-13, 308 mA +/- 80). With instillation of the solution before RFA (group B), coagulation necrosis was greater (14.9 mm +/- 3.8) than in rabbits not injected (group A: 11.5 mm +/- 2.4; Group A vs. B: p <.05) and in those injected before and during RFA (group C: 12.5 mm +/- 3.1; Group B vs. C: p >.05). Conclusion: RFA using HS instillation can increase the volume of RFA-induced necrosis of the liver with a single application, thereby simplifying and accelerating the treatment of larger lesions. In addition, HS instillation before RFA more effectively achieves coagulation necrosis than HS instillation before and during RFA.
引用
收藏
页码:27 / 34
页数:8
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