CAJ | 학술논문

目的比较不可逆电穿孔(IRE)与射频消融后肝脏的再生情况.方法 10只实验小猪均分为IRE和射频两组.CT引导下对小猪肝脏行IRE或射频消融,每只动物肝脏消融2处.比较两种消融的细胞死亡、再生及恢复时间.定期行超声、CT、MRI和病理检查.结果消融后即刻,影像学显示两组消融灶体积相近.IRE消融后3d,见肝细胞凋亡,肝小叶内红细胞增多,纤维结构完整,成纤维细胞增生.IRE消融后3周,消融灶消失或显著缩小,与周围正常肝脏分界不清,无纤维包膜形成.射频消融后3周,消融区无明显缩小,纤维包膜形成,与正常肝脏分界清楚.结论 IRE消融后肝脏再生较快,基质结构保存较好.
목적 비교불가역전천공(IRE)여사빈소융후간장적재생정황.방법 10지실험소저균분위IRE화사빈량조.CT인도하대소저간장행IRE혹사빈소융,매지동물간장소융2처.비교량충소융적세포사망、재생급회복시간.정기행초성、CT、MRI화병리검사.결과 소융후즉각,영상학현시량조소융조체적상근.IRE소융후3d,견간세포조망,간소협내홍세포증다,섬유결구완정,성섬유세포증생.IRE소융후3주,소융조소실혹현저축소,여주위정상간장분계불청,무섬유포막형성.사빈소융후3주,소융구무명현축소,섬유포막형성,여정상간장분계청초.결론 IRE소융후간장재생교쾌,기질결구보존교호.
Objective To compare liver regeneration after radiofrequency ablation versus irreversible electroporation (IRE).Methods A total of 10 pigs were divided into IRE and radiofrequency ablation groups.And two ablation foci were established in the liver of each pig.Computed tomography (CT)-guided IRE and radiofrequency ablation were performed.Cell death,liver regeneration and recovery speed were compared.Before ablation,immediately,1 and 3 weeks after ablation,contrast enhanced ultrasound,CT and magnetic resonance imaging (MRI) were regularly performed.Immediately after ablation,24 hours,3 days,3 weeks and 6 weeks,biopsy and pathologic examination were performed.Results At 1-3 days after IRE ablation,apoptotic cells were detected in the ablation zone and numerous red blood cells were present in hepatic cords.Three days after IRE,fibroblasts were found.Three weeks after,most ablation lesions disappeared or significantly reduced.There was no formation of fibrous capsule.And indistinct boundary existed between the surrounding liver tissue and lesion.Immediately after ablation,coagulative necrosis of ablation zone in liver was confirmed.After 3 weeks,all lesions persisted in the radiofrequency ablation group.There was formation of fibrous capsule.Immediately after ablation,the ablation volume was similar between two groups on CT scan.Three weeks later,6 ablation foci in IRE group disappeared while another 4 lesions shrank more than 50％.There was no significant volume reduction in the radiofrequency ablation group.Conclusion Compared with radiofrequency ablation,IRE resulted in faster liver regeneration and intact extracellular structure.