【摘要】 目的探讨热控电极与传统电极在不可逆电穿孔(IRE)消融小鼠肝脏组织中的异同。方法实验组采用热控电极,对照组采用传统电极,分别在CT导引下对18只小鼠(每组9只)经皮肝穿刺释放相同剂量电脉冲。对比两组电极温度变化、消融速率、消融截面积、术后恢复情况、存活率、有效率及组织病理学改变。结果两组经皮肝穿刺均获成功(9/9)。小鼠接受20个电压600 V、场强1 800 V/cm、脉宽100μs、脉冲频率1 Hz的电脉冲处理后,实验组消融用时(32.5±3.5) s,慢于对照组用时(20.0±0) s(P<0.05);电极温度上升(5.3±0.8)℃,低于对照组(18.6±2.3)℃(P<0.05)。术后两组小鼠均存活,消融有效均为7只。实验组有效消融面积(15.2±3.6) mm2,小于对照组(21.3±5.2) mm2(P<0.05)。有效消融区均出现细胞凋亡、消融边界呈细胞级过渡、消融区管腔结构保留完好等典型IRE病理表现。对照组苏木精-伊红(HE)染色出现脱染现象,实验组染色均匀。结论在合理的消融参数下,CT引导经皮穿刺行小鼠肝脏IRE消融实验安全、微创、有效。在同等脉冲剂量条件下,热控电极消融效率不及传统电极,但能有效控制消融中的热效应,使消融更均一,实现真正意义上的非热消融。更多还原

【Abstract】 Objective To investigate the similarities and dissimilarities between thermal-control electrodes and traditional electrodes in the irreversible electroporation(IRE) ablation of the mouse liver.Methods A total of 18 mice of American Institute of Cancer Research(ICR) were equally divided into study group(n=9, using thermal-control electrodes) and control group(n=9, using traditional electrodes). Under CT guidance, percutaneous liver puncture IRE was performed in all experimental mice, during which the same dose of the electric pulse was released. The electrode temperature, ablation rate, area of ablated cross-section,postoperative recovery, survival rate, effective rate and histopathological findings were compared between the two groups. Results Successful percutaneous liver puncture was accomplished in all mice of both groups.After receiving a treatment of 20 electric pulses with a voltage of 600 V, a field strength of 1 800 V/cm, a pulse width of 100 μs, and a pulse frequency of one Hz, the mean time used for the ablation in the study group was(32.5±3.5) seconds, which was longer than(20.0±0) seconds in the control group(P<0.05); the electrode temperature in the study group rose(5.3±0.8)℃, which was remarkably lower than a rise of(18.6±2.3)℃in the control group(P<0.05). Postoperative survival rate of experimental mice was 100% in both groups. The effective rate of ablation was 77.8%(7/9) in both groups(P>0.05). The effective ablated area in the study group was(15.2±3.6) mm2, which was prominently smaller than(21.3±5.2) mm2 in the control group(P<0.05).Typical post-IRE pathological manifestations in the effective ablated zone, such as cell apoptosis, cell-level transition at the border of ablated area, intact lumen structure, etc., could be observed. In the control group,de-staining phenomenon of H&E staining could be found, while uniform staining was seen in the study group.Conclusion When reasonable ablation parameters are adopted, CT-guided percutaneous puncture IRE ablation of mouse liver is safe, mini-invasive and effective. When the same pulse dose was used, the ablation efficiency by using thermal-control electrodes is not as good as that by using traditional electrodes, but the thermal-control electrodes can effectively control the thermal effect during the ablation treatment process,which makes the ablation effect more uniform, thus, the true “non-thermal” ablation goal can be achieved.(J Intervent Radiol, 2022, 31: 62-66)更多还原