HIFU联合HL-1损伤正常兔肝脏组织的体内实验研究

目的　探讨一种脂质体 (HIFU L iposomes- 1,HL - 1)增强兔肝高强度聚焦超声 (high intensity focused ultrasound,HIFU )能量沉积和灰阶超声实时监控的效果。方法　将兔随机分为 A,B两组 ,A组右肝为实验侧 (HL - 1侧 ) ,左肝为生理盐水侧 ,B组相反。输入生理盐水后以一定参数行 A组左肝或 B组右肝 HIFU损伤 ;然后输入 HL - 1以相同参数行对侧组织 HIFU损伤 ;记录 HIFU靶区 B超灰度值。实验后 2 4h解剖 ,测量凝固性坏死组织大小、计算能效因子 (energy efficiency factor,EEF)并行组织病理检查。结果　灰度增强出现率在 A、 B两组的 HL - 1侧均有所增加 ,但差异无显著性 (P>0 .0 5 ) ;A,B两组 HL - 1侧的 EEF均明显低于对照侧 (P<0 .0 1) ;损伤组织大体观及病理检查两组两侧均为典型的凝固性坏死。结论　 HL - 1联合 HIFU能导致靶区组织发生凝固性坏死 ,并有增强正常兔肝脏组织 HIFU能量沉积的作用 ,灰阶超声对靶区组织凝固性坏死的实时监控作用有待进一步研究。

Ablation of Normal Rabbit Liver Tissue by Combination of HL-1 and HIFU:A Vivo Experimental Study

Objective To explore the enhancing effects of HL-1 (HIFU liposome-1) for HIFU energy depositions in target rabbit liver tissue and to real-time monitor the necrotic tissue in the target region with grey scale ultrasound in vivo.Methods Fifty rabbits were divided into two groups,A and B equally.The right liver in group A was the experimental side (HL-1 side),and the left liver was the control side (saline side),and the experimental and control side in group B was reversed.Ablating the left liver (group A) or right liver (group B) with HIFU after saline injection;then,ablating the right liver (group A) or left liver (group B) with HIFU under the same parameters 1 hour after HL-1 injection were performed.The ablating manner (dot or line scan) was the same in two sides in one rabbit.The enhanced BUGs (B ultrasonic grey scale) value appeared in the focal region were recorded in two sides of the two groups.The rabbits were sacrificed 24 hours after the experiment.The size of the ablated tissues was measured and its EEF (energy efficiency factor) causing correspondent tissue damage were calculated.Some tissue in the boundary area between normal and necrosis was chosen for pathological examination.Results The rate of enhanced BUGs was increased slightly in the HL-1 side in two groups (P>0.05),but EEF in HL-1 side was lower than that of saline side in both A and B group(P<0.01);Typical coagulation necrosis was seen under gross and pathological examination in ablated area of both groups.Conclusions Combination of HL-1 and HIFU can cause coagulation necrosis in target rabbit liver tissue,and HL-1 has the function to enhance HIFU energy deposition in the normal tissue,Whether the grey scale ultrasound may be used for monitoring the necrotic tissue ablated by HIFU should be further discussed.