超声引导不可逆电穿孔消融山羊肝脏的实验研究 刘颖1，周玮1，熊正爱 .DOCVIP

超声引导不可逆电穿孔消融山羊肝脏的实验研究 刘颖1，周玮1，熊正爱1，李成祥2，姚陈果2 （1.重庆医科大学附属第二医院妇产科，重庆，400010；2．重庆大学输配电装备及系统安全与新技术国家重点实验室，重庆，400030） [摘要]目的 探讨超声引导经皮穿刺不可逆性电穿孔（irreversible electroporation, IRE）微创消融山羊肝脏组织的可行性、B超影像学特点及病理分析。方法 固定脉宽100μs，频率1Hz，电压2000V，脉冲数120个，彩色超声探头引导电极针经皮定位穿刺处理山羊肝脏组织，观察处理的过程中及处理后即刻、24小时靶区灰度变化，肝脏坏死轮廓与仿真电场相比较，同时对应时间点取材行组织病理切片。结果 超声引导经皮IRE消融靶区组织定位准确，与周围正常组织回声明显不同；光镜下观察治疗处理区肝细胞完全坏死，与周围正常细胞分界清楚；坏死组织轮廓与电极的电场仿真图像相吻合。结论 超声作为一种辅助手段，实时引导定位穿刺，监测处理后坏死区回声变化范围，IRE消融范围精确、可控，为临床前期应用提供了大动物实验依据。 关键词：脉冲电场；不可逆性电穿孔；超声引导；肝脏 Experimental study on goat livers with ultrasound imaging guided percutaneous irreversible electroporation Liu Ying1, Zhou Wei1, Xiong Zhengai1, Li Chengxiang2, Yao Chenguo2 (1. Obstetrics and Gynecology department,the 2nd affiliated hospital of Chongqing Medical University, Chongqing, 400010, 2. State Key Laboratory of Power Transmission Equipment System Security and New Technology; Chongqing, 400010) Abstract Objective To investigate the proper method of percutaneous irreversible electroporation (IRE) on goat livers under ultrasonic guidance, and observe the characteristic of ultrasound imaging and histological feature changes. Methods Pulse electric fields (PEFs) with permanent duration (100 μs), frequency (1Hz), voltage (2000V) and pulses (120 pieces) performed on the electrodes, and placement of the electrodes was performed under ultrasound guidance though the animal skin to the target area. The treated area was observed by ultrasound and microscope, and compared with ?nite element modeling (FEM) methods at the time of 0, 24hours after IRE ablation. Results Ultrasound imaging guidance was accurate to focus on the target area. Imaging captured by the ultrasound after IRE procedure was quite different compared with the normal liver imaging. Complete hepatic cell death with a sharp demarcation between the ablated zone and the non-ablated zone were observed. Necrospy-based measurement demonstrated highly consistency with FEM-anticipated ablation zones. Conclusion With r