实时超声造影评价狗肝微波凝固坏死效果的实验研究

目的探讨实时灰阶谐波超声造影评估活体狗肝微波凝固坏死范围的价值：方法取杂种狗9只，在超声引导下行微波凝固肝组织12处，在不同时间后予常规灰阶超声和实时灰阶超声造影及取大体病理标本测量凝固灶大小。计算体积（分别为V1、V2和V3）。结果（1）V2与V3相关性好（r=0．93，P〈0．01），V1与V3的相关性（r=0．61。P〈0．05）较V2与V3明显为差；（2）即时（30～60min）超声造影因凝固灶内尚存有水蒸气，其效果稍差；3～7d造影，凝固灶周边有环状增强，病理示炎性包裹所致；15d后超声造影能够较好的反映凝固灶的大小。结论常规灰阶超声不能真实显示微波凝阎坏死灶的大小，而实时超声造影能较准确地反映，故可做为临床肝癌微波治疗后的疗效判断的有效手段；微波治疗15d后行超声造影其清晰度更佳。     

HIFU联合Sono Vue损伤含较大血管肝组织的实验研究

目的:探讨HIFU联合SonoVue辐照含有较大血管的靶组织时形成损伤的情况.方法:采用JC型聚焦超声肿瘤治疗系统,对10只南江黄羊正常肝脏进行直线扫描,选择含有3 mm血管肝脏组织作为靶区,试验组HIFU辐照前静脉注射SonoVue,对照组不注射SonoVue.于治疗24 h后过量麻药处死动物,测量肝脏损伤长、宽以及厚,比较有SonoVue组和无SonoVue组凝固性坏死出现率以及凝固性坏死体积有无差异.结果:损伤深度为30 mm,靶组织内含有3 mm血管时,HIFU联合SonoVue能够有效的形成损伤,有SonoVue组和无SonoVue组凝固性坏死出现率以及凝固性坏死体积存在差异,差异有统计学意义(P<0.05).结论:当靶组织内含有较大血管时,SonoVue能够提高HIFU治疗效率,有效的形成损伤.     

常规超声与超声造影对宫内组织物残留诊断价值的比较

目的与常规超声比较,探讨超声造影对宫内组织物残留的诊断价值。方法以病理结果为金标准,比较常规超声及超声造影对45例疑诊宫内组织物残留患者的诊断准确率。结果对于多量组织物残留者,常规超声与超声造影诊断的准确率接近：而对于少量或无组织物残留者,超声造影诊断的准确率高于常规超声。结论超声造影能提高宫内组织物残留诊断的准确率．并能显示残留组织物的供血血管位置以及残留物的多少,可为临床处理提供更多信息。     

声诺维超声造影对兔肾射频消融灶的连续性评价

目的探讨声诺维（SonoVue）超声造影技术对正常肾脏射频消融灶术后效果的连续性评价作用。方法20只新西兰大白兔射频消融术后,采用SonoVue超声造影分别在术后1d、1周、1个月及3个月对消融灶进行观察评价,并将超声造影结果与大体标本消融灶结果对照分析。结果术后1d和1周,射频在兔肾产生的消融灶在切面上呈现楔形改变,传统超声不能显示消融灶的范围,超声造影准确地反映了消融灶的外观和大小,与大体标本消融灶实际的大小相差也仅1mm左右。在术后1个月和3个月时,消融灶在二维超声上呈高回声改变,超声造影可见肾内小的灌注缺损区,与大体测量的肾纤维结节大小相差也在1mm以内。结论SonoVue超声造影技术可以准确地反映正常肾脏射频消融后的发展及演变情况。     

Clinical utility of a microbubble-enhancing contrast (“SonoVue”) in treatment of uterine fibroids with high intensity focused ultrasound: A retrospective study

Purpose

To evaluate the clinical value of the contrast agent SonoVue in the treatment of uterine fibroids with ultrasound-guided high intensity focused ultrasound (HIFU) therapeutic ablation.

Materials and Methods

A total of 291 patients with solitary uterine fibroid from three centers were treated with ultrasound-guided HIFU. Among them, 129 patients from Suining Central Hospital of Sichuan were treated without using SonoVue. 162 patients from the First Hospital of Chongqing Medical University and Chongqing Haifu Hospital were treated with using SonoVue before, during and after HIFU procedure to assess the extent of HIFU.

Results

The non-perfused volume (indicative of successful ablation) was observed in all treated uterine fibroids immediately after HIFU ablation; median fractional ablation, defined as non-perfused volume divided by the fibroid volume immediately after HIFU treatment, was 86.0% (range, 28.8–100.0%) in the group with using SonoVue, and 83.0% (8.7–100.0%) without SonoVue. The rate of massive gray scale changes was higher with SonoVue than without the agent. The sonication time to achieve massive gray scale changes was shorter with SonoVue than without. The sonication time for ablating 1 cm³ of fibroid volume was significantly shorter with using SonoVue than without. No major complications were observed in any patients.

Conclusions

Based on our results, SonoVue may enhance the outcome of HIFU ablation and can be used to assess the extent of treatment.     

经阴道四维子宫输卵管超声造影对不孕症患者的舒适度及准确度的临床观察

目的:评估经阴道四维子宫输卵管超声造影技术(4D-SonoVue-HyCoSy)对不孕症患者的舒适程度及诊断输卵管通畅性的准确度。方法:对655名不孕女性患者行4D-S-HyCoSy,观察患者术中疼痛程度、副反应及术后并发症;以腹腔镜下美兰通液检查的22例为对照,比较其诊断输卵管通畅性的准确度。结果:68.55%患者无明显术中疼痛,19.54%轻度疼痛,9.92%中等疼痛,1.53%重度疼痛。1.98%有轻微迷走神经反应。4D-SHyCoSy诊断输卵管通畅的准确率为90.9%,敏感度90.9%,特异度90.9%,阳性预测值76.9%,阴性预测值96.8%,与腹腔镜检查无明显差异(P=0.625)。结论:采用4D-S-HyCoSy评估输卵管通畅性安全、有效、快捷、准确。     

诊断超声联合微泡促进葡萄糖透皮吸收的研究

目的：通过动物实验研究诊断超声联合微泡对葡萄糖透皮吸收的影响。方法：分对照组及实验组。对照组测定空腹血糖及与溶液接触6 min后血糖。实验组测定空腹血糖,并通过输液泵匀速注入SonoVue混悬液,测定与溶液接触6 min后,测实验兔血糖浓度,分析实验组6 min血糖浓度与对照组6min血糖浓度及实验兔空腹血糖浓度差异。结果：实验兔空腹血糖浓度约为（5.33±0.53）mmol/L,对照组6min血糖浓度约为（5.40±0.50）mmol/L,实验组6 min血糖浓度约为（6.15±0.61）mmol/L,实验组6 min血糖浓度与对照组6 min血糖浓度及实验兔空腹血糖浓度差异有统计学意义,（P〈0.05）。结论：诊断超声联合微泡可促进葡萄糖透皮吸收,其原理可能与SonoVue增强局部空化作用有关。     

Influence of Repetitive Contrast Agent Injections on Functional and Molecular Ultrasound Measurements

Quantitative contrast-enhanced ultrasound plays an important role in tumor characterization and treatment assessment. Besides established functional ultrasound techniques, ultrasound molecular imaging using microbubbles targeted to disease-associated markers is increasingly being applied in pre-clinical studies. Often, repeated injections of non-targeted or targeted microbubbles during the same imaging session are administered. However, the influence of repeated injections on the accuracy of the quantitative data is unclear. Therefore, in tumor-bearing mice, we investigated the influence of multiple injections of non-targeted microbubbles (SonoVue) on time to peak and peak enhancement in liver and tumor tissue and of vascular endothelial growth factor receptor 2 (VEGFR2)-targeted contrast agents (MicroMarker) on specific tumor accumulation. We found significantly decreasing values for time to peak and a tendency for increased values for peak enhancement after multiple injections. Repeated injections of VEGFR2-targeted microbubbles led to significantly increased tumor accumulation, which may result from the exposure of additional binding sites at endothelial surfaces caused by mechanical forces from destroyed microbubbles.     

超声辐照血卟啉单甲醚和声诺维协同杀伤MDA-MB-231细胞的实验研究

目的探讨超声辐照中血卟啉单甲醚(HMME)和声诺维(SonoVue)杀伤人乳腺癌细胞株MDA-MB-231细胞的协同作用。方法将处于对数生长期的MDA-MB-231细胞分为8组(M组、H组、H+M组、U组、U+M组、U+H组、U+H+M组和对照组)。采用优化后的实验参数,以50Hz脉冲波照射60s,以MTT法检测照射后的MDA-MB-231细胞存活率,观察细胞形态学改变。结果 M组、H组、H+M组、U组、U+M组、U+H组、U+H+M组及对照组中MDA-MB-231细胞存活率分别为(91.90±1.41)%、(95.28±3.30)%、(90.76±4.01)%、(77.59±1.52)%、(52.12±2.90)%、(46.72±1.35)%、(31.47±1.48)%和(99.95±0.66)%。U+H+M组细胞存活率与其他各组差异均有统计学意义(P均<0.01)。结论超声辐照时,SonoVue和HMME能够相互协同杀伤MDA-MB-231细胞。     

经阴道三维超声输卵管造影的诊断价值研究

目的研究经阴道三维超声输卵管造影（3D-HyCoSy）对诊断输卵管通畅性的临床价值。方法对50例不孕症患者,采用SonoVue作为造影剂,行经阴道三维超声输卵管造影,与X线子宫输卵管造影（HSG）检查结果进行对照,并将腹腔镜检查作为金标准,比较其对输卵管通畅性的诊断价值。结果 3D-HyCoS与HSG检查结果对照,结果48例完全符合,诊断符合率96%,3D-HyCoSy与HSG的灵敏度和特异度差异无统计学意义（P〉0.05）。结论利用SonoVue超声造影剂进行3D-HyCoSy对输卵管显像清晰,并具有简便易行、无创、无辐射、高效率等优点,对输卵管性不孕症的诊断有较高的临床价值。