经皮纳米刀消融猪肾脏后肾血流灌注的变化

目的 探讨经皮纳米刀消融实验用小型猪肾脏后肾血流灌注的变化。方法 实验用巴马小型猪6头，随机选取每头猪一侧肾脏作为实验组，另一侧作为正常对照组。实验组采用CT导向经皮穿刺技术将纳米刀消融探针置入肾实质内预定治疗区域，正常对照组不采取任何治疗措施。采用CT灌注成像技术，对实验组行不可逆电穿孔消融后，分别于消融术后即刻、2、4、8、16周行双侧肾脏CT灌注成像，分析计算各个时间点肾血流灌注参数，包括肾实质血流量（BF）、血容量（BV）、最大增强值（PE）、达峰时间（TTP）。对不同时间点两侧肾脏实质灌注参数差异进行统计学分析。结果 对6头实验猪均穿刺并消融成功，且在各时间点均成功完成CT灌注成像。消融后即刻实验组BV、BF、PE值均低于正常对照组（P均<0.05），TTP值则高于正常对照组（P<0.05）；消融后2、4、8、16周两组各参数差异均无统计学意义（P均>0.05）。结论 经皮纳米刀肾脏消融术后，急性期可降低消融区肾脏血流灌注，消融后2周消融区血流灌注即可恢复。纳米刀消融肾脏对肾血流灌注的影响暂时且可逆。

Renal blood flow changes after ablation of pig kidney by percutaneous Nanoknife

Objective To investigate the renal perfusion changes after ablation of kidneys in experimental miniature pigs by percutaneous Nanoknife. Methods Six Bama miniature pigs were enrolled. Each side kidney of every pig was randomly selected as experimental group, the contralateral as control group. Nanoknife ablation probe was placed into pre-treatment renal parenchyma of experimental groups by CT guided percutaneous puncture technology following the preoperative planning, the control groups did not take any treatment. After irreversible electroporation ablation in the experimental group, bilateral renal CT perfusion imaging were carried out respectively immediately, 2 weeks, 4 weeks, 8 weeks, 16 weeks after ablation. Renal perfusion parameters including renal blood flow (BF), blood volume (BV), peak enhancement (PE), time to peak (TTP) were analyzed, and statistical analysis was performed. Results Six miniature pigs were punctured successfully, and renal CT perfusion imaging were carried out in each time successfully. Immediately after ablation, BV, BF, PE values of experimental group were lower, TTP was higher than those of the control group (all P<0.05). Meanwhile, 2 weeks, 4 weeks, 8 weeks, 16 weeks after ablation, the statistical analysis of BV, BF, PE and TTP showed no significant difference in both groups (all P>0.05). Conclusion Renal perfusion can be reduced after kidney Nanoknife ablation in the acute phase, but restored 2 weeks after ablation. The effects of Nanoknife ablation of kidney on renal perfusion are temporary and reversible.