高强度聚焦超声辐照离体组织靶区无灰度变化有坏死现象的研究  

Gray value invariance and necrosis formation in target tissue receiving HIFU irradiation

作　　者：邹建中[1] 龚晓波[1] 贺雪梅[2] 唐思佳[3] 

机构地区：[1]重庆医科大学医学超声工程研究所超声医疗国家工程研究中心,重庆市400016 [2]重庆医科大学第二临床学院 [3]重庆医科大学应用技术学院

出　　处：《临床超声医学杂志》2008年第9期581-583,共3页Journal of Clinical Ultrasound in Medicine

基　　金：国家自然科学基金青年杰出基金项目(30325027)

摘　　要：目的研究高强度聚焦超声(HIFU)辐照离体组织靶区时声像图无灰度变化而有坏死的现象。方法应用HIFU辐照新鲜离体牛肝组织,辐照剂量分别为2500,3000,3750,4200J,每个剂量又分为10个辐照功率时间组。超声实时监控HIFU辐照全过程,辐照结束后即刻采集靶区声像图,运用灰度测量软件读取靶区灰度值;重复实验5次。计算灰度增强出现几率。结果总剂量为2500J时,所有的功率时间组均未出现灰度增强;总剂量为3000J时,声功率≥200W出现灰度增强;总剂量为3750J时,声功率≥150W出现灰度增强;总剂量为4200J时,声功率≥120W出现灰度增强。经病理检查证实,各剂量组中,除2500J组辐照参数50W/50s和60W/41s未出现损伤外,其余均出现凝固性坏死。结论组织凝固性坏死后,声像图上多数有灰度增加,但部分没有灰度变化;声像图上显示的HIFU辐照后即刻的灰度增加并不是组织凝固性坏死的直接表现,提示在临床应用时,不要过分依赖声像图变化判断治疗效果。Objective To explore the gray value invariance and necrosis formation in target tissue receiving HIFU irradiation. Methods HIFU with dosage of 2 500 J, 3 000 J, 3 750 J and 4 200 J was used separately to irradiate the fresh ex vivo ox liver, each dosage was divided into 10 irradiance power - time groups. The whole process was monitored by diagnostic ultrasound in real time. Sonograms of the target area were collected immediately after irradiation, and the gray value in the target area was measured by gray scale analysis software. This process was repeated for five times, the probability of gray scale enhancement was calculated by the formula K = N/M ＊ 100%. Results When dosage Was about 2 500 J, no increase in gray value appeared; when it came to 3 000 J, 3 750 J and 4 200 J, the gray value would be increased if the corresponding acoustic power was higher than 200 W, 150 W and 120 W respectively. Pathological examinations confirmed that coagulative necrosis was formed in all groups except for two parameter sets in the 2 500 J group： 50 W/50 s and 60 W/41 s. Conclusion Gray value is generally increased after HIFU irradiation, but not in all the cases. Sonogram gray value increase is not the direct result of coagulative necrosis, which suggests that sonogram gray value variation should not be the only indicator to assess therapeutic efficacy.

关 键 词：高强度聚焦超声 靶区 灰度变化 

分 类 号：R730.5[医药卫生—肿瘤] R730.56[医药卫生—临床医学]