CAJ | 학술논문

目的：通过对活体猪胫骨行经皮多极射频消融（radiofrequency ablation，RFA），观察骨端及骨干多极RFA灶的病理及影像改变，探讨与影像改变对应的病理组织学变化。方法麻醉状态下，于8只实验活体猪胫骨骨端、骨干的相同位置行多极RFA，于术后按实验设定时间处死实验动物，获取骨端、骨干标本，并在此过程中进行活体动物RFA部位X线、CT检查，肉眼观察标本及测量后行骨切片、HE染色，镜下观察。结果 X线及CT检查示骨端多极RFA灶早期无明显影像学改变；随后边缘出现低密度带，为肉芽组织吸收坏死骨质至骨密度减低所致，并向中部逐渐扩展；随后在低密度区外缘见骨质硬化带，为肉芽组织成熟形成的纤维组织内新骨形成所致，并向内缓慢填充。骨干多极RFA灶影像及病理改变大致与骨端相同，但易合并骨干病理性骨折及死骨形成。结论多极RFA灶X线及CT影像改变能反映其病理组织学变化，可作为骨肿瘤RFA灶的有效随访手段。
목적：통과대활체저경골행경피다겁사빈소융（radiofrequency ablation，RFA），관찰골단급골간다겁RFA조적병리급영상개변，탐토여영상개변대응적병리조직학변화。방법마취상태하，우8지실험활체저경골골단、골간적상동위치행다겁RFA，우술후안실험설정시간처사실험동물，획취골단、골간표본，병재차과정중진행활체동물RFA부위X선、CT검사，육안관찰표본급측량후행골절편、HE염색，경하관찰。결과 X선급CT검사시골단다겁RFA조조기무명현영상학개변；수후변연출현저밀도대，위육아조직흡수배사골질지골밀도감저소치，병향중부축점확전；수후재저밀도구외연견골질경화대，위육아조직성숙형성적섬유조직내신골형성소치，병향내완만전충。골간다겁RFA조영상급병리개변대치여골단상동，단역합병골간병이성골절급사골형성。결론다겁RFA조X선급CT영상개변능반영기병리조직학변화，가작위골종류RFA조적유효수방수단。
Objective To observe the pathologic and imaging changes of pig’s diaphysis and epiphysis caused by multi-polar radiofrequency ablation (RFA), and to discuss the relationship between the imaging findings and pathologic changes. Methods Under general anesthesia, RFA was carried out on the upper epiphysis and diaphysis of experimental pig’s tibias. Different operation time was used for RFA according to the experiment scheme, and then the pigs were executed by over anesthesia in order to gain the specimen of the upper epiphysis and diaphysis of the experimental pigs’ tibias. X-ray and CT examination were performed before the experimental pigs were sacrificed. The specimens thus collected were sent for pathological examination, both macroscopically and microscopically. HE dyeing was used. Results X-ray and CT scanning showed that at early stage there was no obvious imaging changes in RFA lesions. Then, low-density zone appeared at the edge of the lesions, which was due to the absorption of the necrotic bone by granulation tissue. Shortly after that, a zone of bone sclerosis emerged around the low-density area, which was due to the new bone formation within the fibrous tissue that was produced by the mature granulation tissue, and the bone tissue slowly filled the lesion. The pathologic and imaging changes of ablated diaphysis were quite the same as those of the epiphysis, but the pathological fracture of epiphysis and the formation of necrotic bone occurred more easily. Conclusion X-ray and CT scanning can reflect the pathologic changes of the ablated lesions created by multi-polar radiofrequency. Therefore, imaging examination can be used as an effective follow- up means for checking the RFA lesions of bone tumor. (J Intervent Radiol, 2014, 23:325-328).