돼지 간문맥 관통 후 고주파치료의 합병증: 영상의학적 소견 = Complications Following Radiofrequency Ablation of the Porcine Liver through Portal Vein Penetration: Radiological Findings

다국어 초록 (Multilingual Abstract)

Purpose: To evaluate complications after radiofrequency ablation (RFA) of the porcine liver through portal vein penetration.
Materials and Methods: Twelve pigs were divided into two groups. In group I (n=11) animals, the portal veins were directly penetrated with an electrode, and in the group II (n=16) animals, the portal veins were located within the expected ablation area. For the group I pigs, RFA were performed for seven minutes after complete portal vein passing of the exposed tip. Gray-scale and Doppler ultrasonography, and CT were performed before and after RFA on the procedure day, and on day two. If any complications were found, the same studies were performed at day seven. We analyzed the presence and extent of thrombotic occlusion, the vascular stricture, the arterioportal shunt, and the presence of an intra-abdominal hemorrhage. We applied Fisher's exact test to compare the complication rate between the two groups;, a value was considered statistically significant if the p-value was less than 0.05.
Results: In the group I animals (n=11), three had complete thrombotic occlusion of the portal vein. Among these three animals,, one had a segmental infarction, and one animal showed a partial occlusion. In the group II animals (n=16), complications were not identified. Statistical analysis revealed the complication rate of group I was significantly higher than that of group II (p=.019).
Conclusion: The portal vein occlusion rate was significantly higher in the portal vein penetrating group than in the non-penetrating group.

국문 초록 (Abstract)

목적: 고주파전극으로 간문맥을 관통한 후 소작을 시행하는 경우 발생하는 합병증에 대하여 평가하고자 하였다.
대상과 방법: 돼지 12마리를 2개 군으로 나누었다. 간문맥을 전극으로 관통한 경우(n=11)를 I군, 소작범위 내에 문맥이 위치하게 한 경우(n=16)를 II군으로 하였다. I군에서는 전극의 노출부위가 혈관을 지나게 하고 7분 동안 소작하였다. 회색조 및 도플러 초음파검사와 전산화단층촬영을 시술 당일 소작 전후와 2일째 시행하여 합병증 유무를 확인하였고, 합병증이 의심되는 소견이 있는 경우 7일째 같은 검사를 시행하였으며, 관통된 간문맥의 혈전에 의한 폐색 유무와 정도, 협착 유무, 동문맥단락 유무, 복강 내 출혈 등을 분석하였다. Fisher exact test로 합병증 발생률에 차이가 있는지를 비교하였고 p-value가 0.05 이하인 경우 유의한 것으로 간주하였다.
결과: I군에 포함된 11개의 혈관 중 혈전에 의한 혈관의 완전 폐색이 3예, 부분 폐색이 1예였고 완전 폐색이 있었던 3예 중 1예에서 간분절 괴사가 있었다. II군에 포함된 16개의 혈관에서는 합병증이 발생하지 않았다. 전체 합병증의 발생 빈도는 혈관을 관통한 군에서 혈관을 관통하지 않은 군보다 유의하게 높았다(p=.019).
결론: 간문맥분지를 관통한 다음 고주파치료를 시행하는 경우 혈전에 의한 혈관폐색의 발생률
이 관통하지 않은 군보다 높은 것을 알 수 있었다.

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