采用CT灌注成像评价猪肾脏经皮纳米刀消融后急性期血流灌注的变化

Evaluation of renal perfusion changes in acute phase with CT perfusion imaging after percutaneous nano knife ablation in pig kidney

目的 探讨采用CT灌注成像评价实验用小型猪肾脏经皮纳米刀消融后急性期肾血流灌注的变化.方法 实验用巴马小型猪6头,按抽签法随机将每头猪两侧肾分成实验组和正常对照组.实验组采用CT导向下经皮穿刺技术,将纳米刀消融探针置入肾实质内行不可逆电穿孔消融,对照组不采取任何治疗措施.消融结束后立即行双侧肾脏CT灌注成像,分别计算2组的肾血流灌注参数,包括主动脉达峰时间（ATTP）及峰值（PAE）,肾实质血流量（BF）、血容量（BV）、最大增强值（PE）和达峰时间（TTP）,并采用配对t检验进行比较.结果 6头小型猪均穿刺并消融成功.ATTP为（24.33±1.63）s,PAE为（440.00±41.95）HU.对照组BF、BV、PE和TTP分别为（66.46± 15.32）ml· 100 ml-1·min-1、（75.91±40.70） ml/100 g、（101.21±51.34）HU和（35.84± 19.04）s,实验组分别为（12.16±6.80）ml·100 ml-1·min-、（19.93± 17.54） ml/100 g、（24.33± 15.51） HU和（61.12±26.74）s,差异均有统计学意义（t值分别为6.40、3.03、3.52和4.63,P均＜0.05）.结论 实验猪肾脏经纳米刀消融术后,急性期消融区肾脏血流灌注降低.

Objective To investigate quantitative changes of renal perfusion in acute phase with CT perfusion imaging after percutaneous nanoknife ablation in experimental miniature pig kedneys.Methods Six Bama miniature pigs were were randomly divided into experimental group and control group.Nanoknife ablation probe was placed into renal parenchyma in experimental groups by means of CT-guided percutaneous irreversible electroporation.Control groups did not receive any treatment measures.Bilateral renal CT perfusion imaging were carried out immediately after ablation.Renal perfusion parameters of two groups were calculated respectively,including aortic time to peak （ATTP） and peak aortic enhancement （PAE）,blood flow （BF）,blood volume （BV）,peak enhancement （PE）,time to peak （TTP）,and were compared using a paired t test.Results Six miniature pigs were punctured and ablated successfully.Mean ATFP was （24.33±1.63） s.Mean PAE was （440.00±41.95） HU.BF,BV,PE and TTP of control groups were （66.46± 15.32） ml＆#183; 100 ml-1· min-1,（75.91±40.70） ml/100 g,（101.21±51.34） HU and （35.84± 19.04） s respectively and those of the experimental groups were （12.16±6.80） ml· 100 ml-1· min-1,（19.93±17.54） ml/100 g,（24.33± 15.51） HU and （61.12± 26.74） s respectively.The differences were statistically significant （t values were 6.40,3.03,3.52 and 4.63,respectively,P〈0.05）.Conclusion Renal perfusion parameters in acute phase are reduced after nanoknife ablation in experimental miniature pigs.