摘要
目的初步评估超声引导激光消融实验兔肾的有效性。方法超声引导下对4只正常新西兰兔肾进行单针或多针激光消融(每根光纤设定功率5W,持续6min,总能量1800J),观察消融过程中和消融结束后二维超声表现及消融结束后消融灶超声造影表现,并观察消融灶大体及镜下病理表现。结果二维超声上消融灶大体呈椭圆形,其中央部分为高回声,周边部分为稍低回声,与周围肾实质分界模糊,内未见血流信号;超声造影示消融灶整体呈无增强;双针消融灶(30mm×15mm)比单针消融灶(13mm×12mm)范围大。大体标本示消融灶中央为碳化区,周边呈粉红色区,与未消融区分界清晰。镜下可见消融灶中央凝固性坏死,周边变性伴间质出血,未消融区组织形态正常且与消融灶分界清晰。结论超声可引导激光对肾脏进行有效消融。结合超声造影,可进一步评估消融效果。多针消融可扩大消融范围。
Objective To evaluate the results of ultrasound-guided percutaneous ablation of rabbits′kidneys using a neodymium-yttrium-aluminum-garnet（Nd：YAG）laser fiber.Methods Four rabbits′ kidneys were ablated with the laser via an optical fiber.Conventional ultrasound was applied for monitoring the process of ablation.Then the contrast-enhanced ultrasound（CEUS）,gross-pathological and histo-pathological features of kidneys were observed after the laser ablation.Results Conventional ultrasound showed that the ablative region was oval in shape with a hyperechoic center surrounded by a mild hypoechoic rim and an unclear ablative margin.There was no blood flow signal in the ablative area at color Doppler imaging.The CEUS showed that ablative area was non-enhanced.With double laser fibers,a larger ablative area was got than using single fiber（30 mm×15 mm vs 13 mm×12 mm）.On gross pathology,tissue carbonization was found in the center of the ablative area and surrounding tissues showed degeneration changes.There was a clear margin between the ablative area and the adjacent normal kidney tissue.On histopathology,tissue coagulation necrosis occurred in the center of the ablative area.Meanwhile,tissue degeneration and interstitial bleeding were found at the peripheral part of the ablative area,and adjacent tissue were normal.Conclusions Ultrasound-guided laser ablation of kidney tissue is effective.Real-time ultrasound guidance facilitates the laser ablation.CEUS provides a fast evaluation of the ablation result.Multiple laser fibers can achieve a larger ablative area compared with single laser fiber.
出处
《中华医学超声杂志（电子版）》
2012年第11期65-68,共4页
Chinese Journal of Medical Ultrasound(Electronic Edition)
基金
国家自然科学基金(30970837)
教育部新世纪优秀人才支持计划项目(NCET-06-0723)
关键词
超声检查
激光
消融技术
肾
兔
Ultrasonography
Lasers
Ablation techniques
Kidney
Rabbits
