不同剂量微泡造影剂在高强度聚焦超声消融活体羊肝组织中的增效效应

目的 探讨不同剂量超声造影剂对高强度聚焦超声(HIFU)消融活体羊肝组织的增效效应.方法 南疆黄羊20只,随机分为4组.第1组为HIFU联合0.01 ml/kg SonoVue.第2组为HIFU联合0.03 ml/kg SonoVue,第3组为HIFU联合0.05 ml/kg SonoVue,第4组为单纯HIFU组.麻醉状态下,微泡造影剂于HIFU辐照前静脉团注,20 s后开始HIFU辐照.每组采用定点辐照,所用辐照参数为频率0.8 MHz、声强19 100 W/cm2、辐照深度30 mm、辐照时间15 s.HIFU辐照结束后1周处死动物.观察并测量凝同性坏死大小,对凝固性坏死作组织病理分析.结果 在相同声辐照参数下,1、2、3组凝同性坏死区域均大于第4组,差异有统计学意义(P<0.05),且凝固性坏死体积随SonoVue剂量的增加而逐渐增大,差异有统计学意义(P<0.05).组织病理学检查发现凝同性坏死区内无正常组织残留.除实验3组出现消融灶邻近组织和皮肤损伤外,其余各组均未出现明显并发症.结论 微泡造影剂在HIFU消融过程中的增效效应与微泡造影剂的剂量有关,微泡造影剂的剂量越大,所形成的凝固性坏死的体积越大,增效越明显.

Enhancing effects of microbubble contrast agent of different dosage on high-intensity focused ultrasound ablation in goat liver in vivo

Objective To investigate the enhancing effect of microbubble contrast agent SonoVue of different dosage on high-intensity focused ultrasound (HIFU) ablation in goat livers in vivo. Methods Twenty goats were divided into 4 groups randomly. Animals in group 1,2 and 3 were bolus-injected of 0.01 ml/kg,0. 03 ml/kg and 0.05 ml/kg of SonoVue intravenously before HIFU exposure, respectively,and those in group 4 were not given injections as control. After injection 20s, the livers were ablated using HIFU performed in the manner of a single dot set by a computer system using a clinical device. The frequency of HIFU was 0.8 MHz,the intensity of HIFU was 19 100 W/cm2 ,the distance from skin to the target liver tissue was 30 mm,the exposure time was set at 15 s for all animals in the four groups. All animals were euthanized 7 days after HIFU, volumes of coagulated necrosis were measured. Pathological examinations were performed to analysis the exposure regions. Results Under the same parameters of exposure, coagulated volumes in group 1,2 and 3 were larger than those in group 4, the difference was significant (P < 0.05),and the coagulated volumes increased gradually with the dosage of SonoVue increasing from group 1 to group 3, the difference was significant (P<0.05). Pathological examinations confirmed that there were no residual unaffected tissues within the exposed volume. Two remarkable changes were observed in one goat in group 37 days after HIFU:the surrounding adjacent tissue outside the reactive zone necrotized and the skin were destroyed. Conclusions The enhancing effects of microbubble contrast agent in HIFU ablation is related with the dosage of the microbubble contrast agent SonoVue. The higher the SonoVue dosage,the larger the volume destroy in the target tissue.