Abstract

Objectives: Contrast-enhanced computed tomography (CECT) is used to monitor technical success immediately after hepatic microwave ablation (MWA). However, it remains unclear, if CECT shows the exact extend of the thermal destruction zone, or if tissue changes such as peri-lesionary edema are depicted as well. The objective of this study was to correlate immediate post-interventional CECT with histological and macroscopic findings in hepatic MWA in porcine liver in vivo.

Methods: Eleven MWA were performed in porcine liver in vivo with a microwave generator (928 MHz; energy input 24 kJ). CECT was performed post-interventionally. Livers were explanted and ablations were bisected immediately after ablation. Samples were histologically analyzed after vital staining (NADH-diaphorase). Ablation zones were histologically and macroscopically outlined. We correlated histologic findings, macroscopic images and CECT.

Results: Three ablation zones were identified in histological and macroscopic findings. Only one ablation zone could be depicted in CECT. Close conformity was observed between histological and macroscopic findings. The ablation zone depicted in CECT overestimated the histological avital central zone and inner red zone (p < = .01). No differences were found between CECT and the histological outer red zone (p > .05).

Conclusions: Immediate post-interventional CECT overestimated the clinically relevant zone of complete cell ablation after MWA in porcine liver in vivo. This entails the risk of incomplete tumor ablation and could lead to tumor recurrence.

摘要

目的：对比增强计算机断层扫描（CECT）用于监测肝微波消融（MWA）后的技术成功。但是，尚不清楚，CECT是否显示了热破坏区的确切范围，或者是否还描绘了组织变化，如病灶周围水肿。这项研究的目的是将猪肝内MWA的介入治疗后立即进行的CECT与组织学和宏观发现相关联。

方法：用微波发生器（928 MHz；能量输入24 kJ）在猪肝体内进行11次MWA 。介入治疗后进行了CECT。切除肝后，立即将其切成两半。活体染色（NADH-心肌黄递酶）后对样品进行组织学分析。在组织学和宏观上概述了消融区。我们关联了组织学发现，宏观图像和CECT。

结果：在组织学和宏观发现中确定了三个消融区。CECT中只能描绘一个消融区。在组织学和宏观发现之间观察到了紧密的一致性。CECT中描述的消融区高估了组织学的禽类中央区和内部红色区（p  <= 0.01）。在CECT和组织学外部红色区域之间未发现差异（p  > .05）。

结论：介入后立即进行的CECT高估了猪肝MWA后体内完整细胞消融的临床相关区域。这带来了不完全消融的风险，并可能导致肿瘤复发。