高强度聚焦超声对恶性实体肿瘤血管的破坏作用

目的：探讨高强度聚焦超声（HIFU）体外破坏恶性实体肿瘤血管的临床影像学变化和病理学变化。方法：HIFU治疗恶性实体肿瘤患者164例，通过数字减影血管造影、彩超、放射性核素显影分析肿瘤血管治疗前后的功能状态；30例患者治疗后常规外科手术，观察肿瘤血管的病理学变化。结果：临床影像学检查显示与治疗前比较，治疗后肿瘤异常血管网被破坏，肿瘤内血供减少或消失；光镜下肿瘤毛细血管、小血管管壁结构出现不可逆性损伤表现，腔内有血栓形成。结论：HIFU能从体外破坏肿瘤血管，加强了HIFU杀死肿瘤细胞的直接效应，这种选择性破坏血管作用有重要的临床意义。

Tumor vessel damage resulting from high-intensity focused ultrasound in patients with malignant solid tumor

Objective To explore the sequential imaging and pathological alternations of tumor vessels in patients with malignant solid tumors after extracorporeal treatment of high intensity focused ultrasound (HIFU).Methods A total of 164 patients with malignant solid tumors underwent extracorporeal HIFU treatment.Color Doppler ultrasound imaging,dynamic radionuclide scanning,and digital subtraction angiography were performed to monitor the response of tumor vessels to HIFU treatment.For histological study,radical surgery was performed in 30 patients no more than 2 weeks after HIFU treatment.Results Compared to tumor images in the patients before HIFU,clinical imagings showed an abrupt interruption,followed by the cessation of blood flow within tumor vessels after HIFU treatment.The histological examination indicated that small tumor vessels were severely damaged by HIFU treatment,with distortion and necrosis of vessels.Scattered intravascular thrombi were frequently seen in the destructive vessels.Conclusion HIFU could extracorporeally destroy small tumor vessels,then indirectly strengthen the destructive force of HIFU on tumor tissue.This selective damage to small tumor vessels would have an important significance in clinical application.