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目的:在离体猪甲状腺组织上比较微波消融(MWA)、射频消融(RFA)、激光消融(LA)的消融特性和温度变化,为临床制定消融方案提供参考。方法:将150个新鲜离体猪甲状腺均分为3组,分别行MWA(20 W 5 min)、RFA(5 W)、LA(3 W 1200 J),各组消融同时在靶心处进行实时测温和超声观察,消融结束后沿针道剖开,观察消融灶形态,计算消融灶体积并进行病理学检查。结果:3组间比较,MWA组消融体积最大(1 597.09 mm~3),LA组次之(780.89 mm~3),RFA组最小(162.20 mm~3),差异均有统计学意义(均P<0.05)。MWA及RFA温升曲线陡直,而LA温升曲线平缓,但最高温度最高(200.9℃)。RFA组消融区域组织分布均匀,未见到明显的炭化和气化空腔;MWA组消融区域可见碳化,但无明显气化空腔;LA组消融灶中央可见碳化与气化空腔。消融灶由内向外,RFA组为凝固坏死区、充血反应区;MWA组为炭化区、凝固坏死区及充血反应区;LA组为气化空腔区、炭化区、凝固坏死区及充血反应区。结论:MWA、RFA及LA的消融范围、温升曲线及消融区病理变化存在差异,了解各自的消融特点有利于3种消融技术的合理应用。
Objective: To compare microwave ablation (MWA), radiofrequency ablation (RFA) and laser ablation (LA) ablation characteristics and temperature changes in isolated porcine thyroid tissue for reference for the development of ablation programs. Methods: Thirteen freshly isolated pig thyroid glands were divided into three groups: MWA (20 W 5 min), RFA (5 W), and LA (3 W 1200 J) respectively. Simultaneous ablation of each group at the bull’s- Mild ultrasound observation, after cutting off along the needle tract after ablation, observe the morphology of the lesion, calculate the volume of lesions and pathological examination. Results: The MWA group had the largest volume of ablation (1 597.09 mm ~ 3), LA group (780.89 mm ~ 3) and RFA group (162.20 mm ~ 3), the differences were statistically significant (P <0.05). The temperature rise curve of MWA and RFA is steep, while LA temperature rise curve is gentle, but the highest temperature is the highest (200.9 ℃). There was no obvious carbonization and gasification cavities in the ablation area of RFA group. Carbonization was observed in the ablation area of MWA group, but no obvious gasification cavities were observed in the ablation area of MWA group. The RFA group was coagulation necrosis and hyperemia reaction zone. The MWA group was carbonized zone, coagulation and necrosis area and hyperemic reaction zone. LA group was gasification cavity area, carbonization area, coagulation and necrosis area and hyperemic reaction area . Conclusion: There are differences in the ablation range, temperature rise curve and the pathological changes of ablation zone between MWA, RFA and LA. Understanding the ablation characteristics of MWA, RFA and LA is beneficial to the rational application of three kinds of ablation techniques.