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目的评估在一个活体血流灌注牛肝脏模型中,增加门静脉血流率对于射频(RF)和微波消融(MW)的治疗范围是否有显著影响。材料与方法本研究获得了动物管理和使用委员会的批准与豁免。在15例活体内灌注牛肝脏模型中应用自体血液通过门静脉以60、70、80、90和100mL/min×每100克肝脏组织进行灌注(每种流率应用于3例肝脏模型进行实验),共进行60次消融治疗(30次微波消融和30次射频消融)。每个消融灶均进行长轴直径(LAD)、短轴直径(SAD)和体积的测量。一般线性混合模型用于检测位置、消融装置和血流量对于LAD、SAD和体积的影响。结果表明其差异具有统计学意义(P<0.05)。结果位置对于LAD、SAD和体积没有显著的预测意义(P≥0.4)。血流速率与LAD、SAD和体积之间关系曲线的斜率根据消融装置的不同有显著的差异(P<0.0001)。RF消融灶的平均LAD、SAD和体积与血流率存在显著的负相关,而MW灶大小测量值并未随血流流率变化而改变。结论 RF消融病变的大小是高度可变的,与门静脉血流率存在显著负相关。相反,MW射频病灶的大小未受门静脉血流变化的影响。MW消融灶大小的恒定性可以理解为,相对于RF消融治疗,MW消融具有更高的局部肿瘤灭活率。
Objectives To assess whether increasing the portal venous flow rate has a significant effect on the therapeutic range of radio-frequency (RF) and microwave ablation (MW) in a live-bovine liver model. Materials and Methods The study was approved and exempted by the Animal Management and Use Committee. In 15 in vivo bovine liver models, autologous blood was infused through the portal vein at 60, 70, 80, 90 and 100 mL / min x per 100 g of liver tissue (each flow rate was applied to three liver models) A total of 60 ablation procedures were performed (30 microwave ablations and 30 radiofrequency ablations). Each lesion was measured for major axis diameter (LAD), minor axis diameter (SAD), and volume. The general linear mixed model is used to examine the effect of site, ablation device, and blood flow on LAD, SAD, and volume. The results showed that the difference was statistically significant (P <0.05). Results There was no significant predictive value for LAD, SAD and volume (P ≥ 0.4). The slope of the blood flow rate versus LAD, SAD, and volume was significantly different (P <0.0001) depending on the ablation device. There was a significant negative correlation between mean LAD, SAD and volume and blood flow rate in RF ablation lesions, but the size of MW lesions did not change with changes in blood flow rate. Conclusions The size of RF ablation lesions is highly variable and has a significant negative correlation with portal venous flow rate. In contrast, MW RF lesions were not affected by changes in portal blood flow. It is understood that MW ablation size invariance has a higher local tumor inactivation rate relative to RF ablation therapy.