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目的探讨活体和离体猪肝模型2 450 MHz微波消融尖端功率与凝固区大小的关系。方法微波消融研究包括30个离体猪肝和25个活体猪肝消融位点。尖端功率分别设置为40、60和80 W,消融时间设置为6min。球形指数简化为r_1~2/r_2~2(r_1:短轴;r_2:长轴)。结果在活体和离体猪肝模型中,微波消融凝固区的大小随尖端功率的提高明显增大。在离体猪肝模型中,尖端功率为80W,凝固区最大短径和长径分别为(25.8±0.8)mm和(49.3±2.2)mm;活体猪肝模型中凝固区最大短径和长径分别为(38.0±3.8)mm和(52.8±9.1)mm。尖端功率提高可以显著减小凝固区球形指数(40 W为0.4±0.2,80 W为0.3±0.0),差异有统计学意义(P=0.018)。病理提示消融区包括3部分:中心区域的碳化区、围绕碳化区周围的凝固坏死区以及最外层的充血边缘。结论微波消融中尖端功率可以显著影响凝固区的大小。
Objective To investigate the relationship between the tip power of 2 450 MHz microwave ablation in vivo and ex vivo porcine liver models and the size of the coagulation zone. Methods Microwave ablation studies included 30 ex vivo porcine liver and 25 live pig liver ablation sites. The tip power was set at 40, 60 and 80 W respectively, and the ablation time was set at 6 min. The spherical index is reduced to r_1 ~ 2 / r_2 ~ 2 (r_1: minor axis; r_2: major axis). Results In live and ex vivo porcine liver models, the size of microwave ablation coagulation zone increased significantly with the increase of tip power. In the ex vivo porcine liver model, the tip power was 80W, and the maximum short axis and long axis in the coagulation zone were (25.8 ± 0.8) mm and (49.3 ± 2.2) mm, respectively. The maximum short axis and the long axis Respectively (38.0 ± 3.8) mm and (52.8 ± 9.1) mm. The increase of tip power can significantly reduce the spherical index of coagulation zone (40 ± 0.4 ± 0.2 and 80 ± 0.3 ± 0.0), the difference was statistically significant (P = 0.018). The pathology suggests that the ablation zone consists of three parts: the carbonation zone in the central area, the coagulation necrosis zone around the carbonation zone, and the outermost congested margin. Conclusion The tip power in microwave ablation can significantly affect the size of the coagulation zone.