Radio-frequency tissue ablation: Effect of pharmacologic modulation of blood flow on coagulation diameter

被引:183
作者
Goldberg, SN [1 ]
Hahn, PF [1 ]
Halpern, EF [1 ]
Fogle, RM [1 ]
Gazelle, GS [1 ]
机构
[1] Massachusetts Gen Hosp, Dept Radiol, Boston, MA 02114 USA
关键词
blood; flow dynamics; interventional procedures; technology; liver; US; radiofrequency (RF) ablation; blood supply;
D O I
10.1148/radiology.209.3.9844671
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
PURPOSE: To determine whether vasoactive pharmacologic agents can alter radio-frequency (RF)-induced coagulation necrosis by modulating hepatic blood flow. MATERIALS AND METHODS: RF ablation was performed in normal, in vivo porcine liver with 1.5-cm internally cooled electrodes and a standardized RF application (ie, 500 mA for 10 minutes). Ablation was performed without (n = 9) and with pharmacologic modulation of blood flow with halothane (n = 7), vasopressin (n = 6), or epinephrine (n = 7). Laser Doppler techniques were used to quantify changes in hepatic blood flow. Remote thermometry was also performed. Blood flow was correlated with both induced coagulation necrosis and tissue temperatures. RESULTS: Halothane reduced mean blood flow (+/- SD) to 46.1% +/- 8.5 of normal, and vasopressin increased mean blood flow to 132.7% +/- 13.9. Epinephrine caused increased hepatic blood flow centrally (171.1% +/- 31.7) but not peripherally (102.8% +/- 15.4). Mean coagulation diameter was 1.4 cm +/- 0.3 with vasopressin, 2.2 cm +/- 0.4 with normal blood flow, and 3.2 cm +/- 0.1 with halothane (P < .01). After epinephrine infusion, mean coagulation measured 2.3 cm +/- 0.3 peripherally and 1.4 cm +/- 0.5 centrally (P < .01). A linear correlation between coagulation diameter and blood flow was demonstrated (r(2) = 0.78). Temperatures 10 and 15 mm from the electrode correlated with both blood flow and coagulation diameter (r(2) = 0.65 and 0.60, respectively). CONCLUSION: The coagulation necrosis achieved for a standardized RF application correlates with relative tissue perfusion. Pharmacologic reduction of blood flow during thermally mediated percutaneous ablation may induce greater coagulation necrosis.
引用
收藏
页码:761 / 767
页数:7
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