Objective:To determine the effect of cryoablation on renal parenchyma, renal microcirculation and collecting system in the porcine kidney. This experiment showed theoretical basement for the safety and efficacy of renal tumor cryoablation. Methods: Eight wuzhishan pig inbreeding line (WZSP) were divided into two groups, the experiment group included 6 swine which were treated with cryoablation procedures under the guidance of optical tracking system (iPath 200. Philips Medical System). Cryoablation was performed using a high-pressure argon system (Cryo-Hit system) with a double freeze/thaw cycle. A 1. 47 mm MR-compatible cryoprobe was advanced into the target near the collecting system; The control group two swine, only puncture. The iceball can be tracked dynamically during the procedure. Follow-up dynamic MR imagings were obtained after 1. 14 and 30 days of the operation. Results:In the animal experiments, the puncture was successful in all 8 cases. 10 minutes after freezing, the iceball was mostly located in the target tissue with the largest diameter,appear as oval-shaped low signal. 1. 5T T1 WI and T2 WI of the target tissue after the protocol showed low signal with discontinuous patchy high signal (ribbon bleeding area), surrounding edema signal. After the injection of GD-DTPA, homogeneous enhancement ring can be seen around the iceball without center enhancement. Conclusion s MR-guided puncture is of high accuracy. No evidence of damage to the renal collecting system secondary to freezing is found. These data have clinical relevance for treatment of a small, localized, central renal tumor in proximity to the pelvicaliceal system without damage to the collecting system.%目的:评价冷冻消融对猪肾实质、肾脏微循环、集合系统的影响,为临床冷冻消融肾脏肿瘤的可行性及安全性提供实验理论依据.方法:五指山小型实验猪实验组6头,ipath200光学系统导引下1.47mm氩氦冷冻探针植入集合系统周围,冻融两个循环；对照组2头,仅行穿刺.术中动态监测冰球形成情况.术后1天、14天、30天分别行1.5T高场磁共振检查.结果:实验猪均穿刺并冷冻消融成功.冷冻10min,冰球最大并大部分位于靶组织内,显示为椭圆形极低信号影.术后1.5TMR显示靶区组织T1W1、T2 W1均呈低信号伴周围不连续的斑片状高信号出血带.周围可见水肿信号.注入GD-DTPA后,冷冻中心无明显强化,周边见均匀强化环.结论:MR导向穿刺准确率高,未发现继发于冷冻的集合系统损伤,对于小肾癌、局限性的累及集合系统的肾肿瘤安全可行.
展开▼
