Abstract

Purpose

To explore the differences in ablation zone between liver cirrhosis and normal liver background and investigate the effect of hepatic blood flow on ablation zone of RFA.

Methods

Between 2017 and 2019, 203 patients who had liver malignancies and underwent percutaneous RFA with Celon bipolar electrodes enrolled into this study. There were 90 patients had liver cirrhosis and 113 patients had normal liver background. They were 63 females and 140 males with average age of 59.0 ± 10.9 years old. Contrast-enhanced CT/MRI was used to evaluate the ablation zone in one month after RFA. The hepatic flow measurements on CDFI and CEUS were performed before RFA. Correlations between ablation zone versus hepatic flow were assessed using multiple linear regression analysis.

Results

The average ablation zone in cirrhotic liver was significantly larger than those in normal liver background with 3 cm tip of RF electrodes (length 3.5 ± 0.5 vs 3.1 ± 0.4 cm, p = 0.001; width 2.6 ± 0.3 vs 2.2 ± 0.3 cm, p < 0.001; thickness 2.5 ± 0.3 vs 2.0 ± 0.2 cm, p < 0.001). The similar result was found with three 4 cm tip of RF electrodes (width 3.6 ± 0.5 vs 3.1 ± 0.5 cm, p = 0.019; thickness 3.3 ± 0.5 vs 2.7 ± 0.5 cm, p = 0.002). The multiple linear regression analysis showed arrive time of hepatic vein and portal vein was statistically associated with ablation zone with 3 cm electrodes (p < 0.001, p = 0.001), but explained part of the variance (Adjusted R²=0.294, adjusted R²=0.212).

Conclusion

The ablation zones of RFA with multi-bipolar electrodes in liver cirrhosis were significantly larger than those in normal liver background, being up to 6 mm in thickness. The hepatic flow parameters partly contributed to the ablation zone.

中文翻译：

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肝硬化与正常肝本底之间多双极射频消融的消融区有什么区别？–前瞻性临床研究

摘要

目的

探讨肝硬化与正常肝本底之间消融区的差异，并研究肝血流量对RFA消融区的影响。

方法

在2017年至2019年之间，本研究纳入了203位患有肝恶性肿瘤并经Celon双极电极进行经皮RFA的患者。有90例肝硬化患者和113例具有正常肝本底的患者。他们是63名女性和140名男性，平均年龄为59.0±10.9岁。RFA后1个月，采用对比增强的CT / MRI评估消融区。在RFA之前对CDFI和CEUS进行肝流量测量。使用多元线性回归分析评估消融区与肝血流之间的相关性。

结果

肝硬化肝的平均消融区明显大于正常肝本底的消融区，射频电极尖端为3 cm（长度3.5±0.5 vs 3.1±0.4 cm，p  = 0.001；宽度2.6±0.3 vs 2.2±0.3 cm，p  < 0.001;厚度2.5±0.3 vs 2.0±0.2 cm，p  <0.001）。在三个4 cm的RF电极尖端上发现了相似的结果（宽度3.6±0.5 vs 3.1±0.5 cm，p  = 0.019;厚度3.3±0.5 vs 2.7±0.5 cm，p  = 0.002）。多元线性回归分析显示，肝静脉和门静脉的到达时间与3 cm电极的消融区在统计学上相关（p  <0.001，p = 0.001），但说明了部分方差（调整后的R ² = 0.294，调整后的R ² = 0.212）。

结论

肝硬化患者中，多极电极对RFA的消融区明显大于正常肝本底，厚度达6 mm。肝血流参数部分有助于消融区。