目的研究经皮射频消融(RFA)治疗椎体肿瘤时椎管及椎体肿瘤内温度变化情况。方法采用CT引导经皮穿刺法将VX2瘤块接种人8只新西兰大白兔的腰椎内,建立兔椎体肿瘤模型。CT引导下对8只建模成功动物行RFA治疗。治疗开始后每间隔30S分别记录治疗椎体肿瘤及同水平椎管内的温度.比较不同时间点椎管及椎体内温度之间有无差异。结果治疗过程中肿瘤内温度迅速上升至90℃并保持稳定。而消融时间持续3min后,椎管内温度超过42%。不同时间点的肿瘤与椎管内温度差异有统计学意义(P〈0.05)。结论应用RFA治疗椎体肿瘤,可使病灶温度在短时间内升高至有效治疗温度,并保持相对稳定。延长消融时间将增加椎管内温度而可能造成神经损伤。
Objective To investigate the temperature variation within intra-spinal canal and intra spinal tumor during percutaneous radiofrequency ablation (RFA) procedure for vertebral tumor in experimental rabbits. Methods Eight New Zealand white rabbits were transplanted with VX2 carcinoma in the lumbar vertebral body by percutaneous puncture inoculation technique under CT guidance in order to set up vertebral tumor models. The eight vertebral tumor models were treated with RFA under CT guidance. The temperature within the spinal canal and vertebral tumor of rabbits was measured and recorded every 30 seconds during the RFA treatment. The results were statistically analyzed by paired sampled t text. Results The intra-tumor temperature rose to 90℃ rapidly and remained stable during the whole RFA procedure, whereas the temperature in the spinal canal exceeded 42℃ when treatment time was over three minutes during the procedure. Statistically significant difference in the temperature level during RFA existed between the spinal canal and the vertebral tumor (P 〈 0.05). Conclusion The temperature in the vertebral tumor of rabbit can quickly reach to the therapeutic level during RFA. Prolonging operative time of RFA may hurt the nerve due to high temperature. (J Intervent Radiol, 2014, 23.. 427-430)