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目的：基于不同的肿瘤血供条件，探究冷冻消融过程中的温度和应力变化规律及其对临床消融区域的影响。方法：首先，利用Comsol Multiphysics有限元软件构建由肺肿瘤、肺组织和冷冻探针3个部分构成的肺肿瘤冷冻消融模型，设置冷冻探针温度并将探针有效能量部分作为冷源，分析冷冻消融过程的温度变化。其次，将温度场与应力场耦合，分析距肿瘤中心不同距离的样本点的应力场变化。最后，分析不同肿瘤血供条件下的消融情况。结果：肺组织受损区边缘与冰球边缘间距超过1 cm，肿瘤已被完全消融。与肿瘤中心距离从1 mm增加到10 mm，样本点温差由220℃降低到120℃，与肿瘤中心距离从1 mm增加到10 mm，样本点应力值由1.86×107 N/m2降低到1.64×107 N/m2。在相同的消融条件下，与富血肿瘤相比，乏血肿瘤达到的最低温度更低，达到的最大应力值更大。肺组织在消融周期内产生的位移变化最大值不足0.2 mm。结论：在靠近冷冻探针的中心区域，肺组织发生相变区域存在较大的温度梯度，产生更大的应力，对肿瘤组织造成了不可逆损伤。同时，乏血肿瘤在相同条件下更易达到更大损伤，但整体冷冻消融过程中不会产生显著热收缩，在临床实践中可以忽略冷冻消融造成的形变。
Abstract：Objective To investigate the patterns of temperature and stress variation during cryoablation and their effects on the clinical ablation zone based on different tumor blood supply conditions. Methods First, a lung tumor cryoablation model consisting of a lung tumor, lung tissue and a cryoprobe was constructed using Comsol Multiphysics finite element software. The effective energy part of the probe was set as the cold source, the cryoprobe temperature was set, and the temperature variation during cryoablation was analyzed. Second, the temperature field was coupled with the stress field to explore stress variations at sample points at different distances from the tumor source center. Finally, ablation under different tumor blood supply conditions was evaluated. Results The distance between the edge of the damaged lung tissue region and the ice ball edge exceeded 1 cm, indicating complete tumor ablation. As the distance from the tumor center increased from 1 mm to 10 mm, the temperature difference at the sample points decreased from 220 °C to 120 °C. As the distance from the tumor source center rose from 1 mm to 10 mm, the stress value at the sample points declined from 1.86×107 N/m2 to 1.64×107 N/m2. Under identical ablation conditions, hypovascular tumors had lower minimum temperatures and greater maximum stress values compared with hypervascular tumors. The maximum displacement change in tissue during the ablation cycle was less than 0.2 mm. Conclusion In the central region near the cryoprobe, a large temperature gradient exists in the phase-change zone of the lung tissue, generating great stress and irreversible damage to the tumor tissue. Meanwhile, hypovascular tumors are prone to greater damage under the same conditions when compared with hypervascular tumors, though no significant thermal contraction occurs during the entire cryoablation process, showing that the deformation induced by cryoablation can be considered negligible in clinical practice.
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基本信息:
DOI：10.19745/j.1003-8868.2026071
中图分类号:R734.2
引用信息:
[1]姜力文,张肖,南群.肺肿瘤冷冻消融中的温度场和应力场仿真研究[J].医疗卫生装备,2026,47(05):29-36.DOI:10.19745/j.1003-8868.2026071.
基金信息:
国家自然科学基金项目(31771021)
2026-05-15
2026-05-15