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Rofo 2003; 175(1): 20-27
DOI: 10.1055/s-2003-36612
Übersicht
© Georg Thieme Verlag Stuttgart · New York

Radiofrequenzablation: Grundlagen, Techniken und Herausforderungen

Radiofrequency Ablation: Basic Principles, Techniques and ChallengesP.  L.  Pereira1 , J.  Trübenbach1 , D.  Schmidt1
  • 1Abteilung für Radiologische Diagnostik, Eberhard-Karls-Universität Tübingen
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Publikationsverlauf

Publikationsdatum:
14. Januar 2003 (online)

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Zusammenfassung

Die Radiofrequenzablation ist eine vielversprechende und sich schnell weiterentwickelnde Technik zur minimal invasiven Therapie von Lebermalignomen. Bis vor einigen Jahren war der limitierende Faktor dieses Verfahrens der unter Verwendung der zur Verfügung stehenden Ablationssonden maximal erzeugbare Läsionsdurchmesser von 1,6 cm. Entscheidende Fortschritte erfuhr dieses Verfahren durch die Entwicklung leistungsfähigerer Generatoren (bis 250 Watt) in Kombination mit offen oder geschlossen gekühlten Ablationssonden bzw. expandierbaren Ablationssonden. Hiermit sind nunmehr Ablationsareale mit Durchmessern bis über 5 cm in-vivo möglich. Weiterhin konnte mit angiographischen bzw. pharmakologischen Strategien eine weitere Vergrößerung der Ablationsvolumina erzielt werden. In diesem Artikel werden die grundlegenden Prinzipien der RF-Ablation sowie die aktuellsten RF-Systeme im Hinblick auf die Ablationscharakteristika dargestellt.

Abstract

Radiofrequency (RF) thermal ablation is a promising and rapidly evolving technique for the minimal invasive treatment of liver malignancies. Until a few years ago, conventional RF treatment performed with a single monopolar electrode produced thermal necrosis lesions not exceeding 1.6 cm in diameter. Substantial improvements in the RF technique included the development of high-power generators (up to 250 watts) combined with open-perfused electrodes, internally cooled-tip electrodes or expandable electrode needles, capable of ablating an area of over 5 cm in diameter. Moreover, angiographically and pharmacologically assisted strategies were introduced for expanding the volume of RF-induced coagulation necrosis. This article presents a synopsis of current RF techniques and reviews the basic principles of RF ablation with the goal of providing guidance for optimal results.

Schlüsselwörter

Leber - Leber, Neoplasma - Leber, Therapie - Ablation, Radiofrequenz

Keywords

Liver - liver, neoplasms - liver, therapy - ablation, radiofrequency

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PD Dr. med. Philippe L. Pereira

Eberhard-Karls-Universität Tübingen
Abteilung für Radiologische Diagnostik

Hoppe-Seyler-Strasse 3

72076 Tübingen

Telefon: +49 7071 2986676

Fax: +49 7071 295694

eMail: philippe.pereira@med.uni-tuebingen.de