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目的:探讨不可逆性电穿孔(irreversible electroporation,IRE)对消融区域内血管结构的影响。方法:固定脉宽100μs,频率1 Hz,电压2 000 V,脉冲数120个,彩色超声探头引导电极针经皮选择血管区域消融山羊肝脏组织,处理后24 h复查超声了解消融区内血管二维超声及多普勒血流影像学变化。对消融区内血管以及周边肝脏组织取材,行HE及Masson染色,通过组织病理学方法评价组织损伤情况。结果:IRE作用范围区域内肝脏组织被完全消融,而大体标本显示血管结构完好,超声影像提示消融区内直径为2.47 mm的血管连续性完整,走行清晰,彩色多普勒血流显像(color doppler flow imaging,CDFI)可以观察到血管内彩色多普勒血流频谱。血管组织学染色示内皮细胞连续性完好,血管周围胶原纤维、血管平滑肌结构完整。结论:IRE消融后靶区内肝脏小动脉、小静脉及肝内胆管结构无损伤,从而为生长在大血管周围、手术进行有困难的肿瘤消融提供可能。
Objective: To investigate the effect of irreversible electroporation (IRE) on the vascular structure in ablation area. Methods: Fixed pulse width of 100μs, frequency of 1 Hz, voltage of 2000 V, number of pulses of 120, color ultrasound probe guided electrode needle percutaneous selection of the blood vessel area ablation goat liver tissue 24 h after treatment ultrasound understanding of two-dimensional Ultrasound and Doppler flow imaging changes. The blood vessels in the ablation area and the surrounding liver tissue were drawn and stained with HE and Masson to evaluate the tissue damage by histopathology. Results: The liver tissue was completely ablated in the region of IRE, while the gross specimen showed good vascular structure. Ultrasound images showed that the diameter of 2.47 mm in the ablation zone was continuous and the blood flow was clear and the color Doppler color flow imaging doppler flow imaging, CDFI) can be observed intravascular color Doppler flow spectrum. Vascular histological staining showed that the integrity of endothelial cells was intact, the perivascular collagen fibers and vascular smooth muscle were intact. CONCLUSION: The structures of hepatic arterioles, venules and intrahepatic bile ducts in target area after IRE ablation are not damaged, which makes it possible to grow tumors around the large vessels and perform surgical ablation of difficult tumors.