目的:比较CT引导下射频消融与热化疗对猪正常胰腺的影响,探讨两种方法用于治疗胰腺肿瘤的安全性及可行性。方法:CT引导下对24只正常小猪胰腺尾部分别进行射频消融(12只)及热化疗(12只)干预,分别于干预后1h、3d、7d和14d复查胰腺CT及MRI、检测血清淀粉酶及测量坏死区最大层面面积。从第3天开始,每组每次复查后均处死4只猪,将影像学表现与大体病理对照。结果:CT引导下射频消融及热化疗干预后第3天,猪胰尾部坏死灶最明显,7~14d胰尾坏死灶逐渐缩小。影像检查结果与大体病理相符合。术后血清淀粉酶均出现一过性升高,3d血清淀粉酶水平最高,7d逐渐降低,至第14天接近正常水平,射频消融组术后1h、3d、7d的坏死灶大小及术后3d的血清淀粉酶均高于同期热化疗组,差异均有统计学意义(P〈0.05)。结论:CT引导下射频消融和热化疗均能造成猪正常胰腺明确的局灶性坏死,无严重并发症发生,具有一定安全性,为进一步的临床应用奠定了基础。
Objective:To compare the influences of CT-guided radiofrequency ablation(RFA) and thermochemotherapy on the pancreas in healthy pig,to study the safety and feasibility of these two methods in treating pancreatic tumor.Methods:CT-guided RFA(12 pigs) and thermochemotherapy(12 pigs) were performed at the pancreatic tail of 24 healthy pigs.CT and MRI were performed at 1h,3 day,7 day and 14 day after the above-mentioned interventions and serum amylase was examined.The areas at the level with the largest necrosis showing on imaging examination were measured.Starting from the 3rd day,4 pigs were sacrificed for each group and the image findings were correlated with gross pathology.Results:The necrotic areas were most obvious at the 3rd day after RFA and therochemotherapy,then reduced gradually at the 7th day and 14th day.The imaging manifestations were in accordance with that of gross pathology.Serum amylase was evanescently increased with highest on the 3rd day and gradually decreased on the 7th day,then it reached the normal level on the 14th day.The sizes of the necrotic area of RFA group at 1h,3rd and 7th day and the serum amylase level at the 3rd day were higher than those of thermochemotherapy at the same period,with significant statistic differences(P0.05).Conclusion: Both CT-guided RFA and thermochemotherapy can lead to obvious necrosis of pancreas without serious complication and its safety provides the basis for clinical application.