低强度超声诱导微泡空化联合凝血酶增强肝肿瘤激光消融作用的实验研究  

The Study on the Enhancement of Laser Ablation of Liver Tumors By Low Intensity Ultrasound Mediated Microbubble Cavitation Combined with Hemocoagulase

作　　者：杨倩 唐鹏 周晓东 Yang Qian;Tang Peng;Zhou Xiaodong(Department of Ultrasonic Diagnosis and Treatment Center Xi'an International Medical Center Hospital,Xi’an,Shanxi 710100,China;Department of Orthopedics,Beijing Charity Hospital of China Rehabilitation Research Center,Beijing 100068.China)

机构地区：[1]西安国际医学中心医院超声诊疗中心,西安市710100 [2]中国康复研究中心北京博爱医院骨科,北京市100068

出　　处：《中国超声医学杂志》2021年第6期698-701,共4页Chinese Journal of Ultrasound in Medicine

基　　金：国家自然科学基金(No.81801708);空军军医大学科技发展基金(No.2019XC033);西安市2020科技计划项目(No.20YXYJ0010)。

摘　　要：目的探讨利用低强度超声诱导微泡空化联合凝血酶降低"热沉降"效应,采用低能量的消融方法,提高风险部位肿瘤热消融治疗的安全性和有效性。方法 120只肝脏种植肿瘤(VX2)的新西兰大白兔随机分为对照组(肿瘤组)、激光组、凝血酶+激光组、低强度超声诱导微泡空化+激光组、低强度超声诱导微泡空化+凝血酶+激光组。利用软件定量分析术前及术后肿瘤微血管灌注。光镜及透射电镜观察消融区及周边区超微结构。结果低强度超声诱导微泡空化+凝血酶+激光组在术后即刻及14 d消融区坏死体积较激光组明显增大(P<0.05)。低强度超声诱导微泡空化+凝血酶+激光组消融区术后即刻及7 d的时间强度曲线峰值、局部血流容积以及曲线下面积均显著低于激光组(P<0.05)。结论低强度超声诱导微泡空化联合凝血酶可降低"热沉降"效应,可提高激光消融对于风险位置肿瘤治疗的安全性和有效性。Objective We aim to investigate both safety and efficacy method for hemocoagulase combined with low intensity ultrasound mediated microbubble cavitation enhanced ultrasound-guided percutaneous laser ablation in rabbit VX2 liver tumors. Methods One hundred twenty rabbits with tumor were divided into 5 groups: Including Control group;Percutaneous laser ablation(PLA) group;Hemocoagulase(HC)+PLA group;Microbubble enhanced ultrasound cavitation(MEUC)+PLA group;MEUC+HC+PLA group. Quantitative analysis contrast enhanced ultrasound of the blood flow of tumor microvascular changes. Results The tumor ablated volume in MEUC+HC+PLA group grow significantly bigger than PLA group 1-day and 14-day(P<0.01). A significant reduction of blood flow of the tumors as a result of the MEUC+HC+PLA treatments than PLA treatment of Peak,(Regional blood volume) RBV and(Area under curve) AUC parameters(P<0.01). Conclusions The results suggest that low intensity ultrasound meiated microbubble cavitation combined with hemocogulase can reduce the "heat deposition" in laser ablation therapy, increase the ablation volume, and improve the safety of tumor ablation therapy at risk sites by blocking the microvascular of liver tumors.

关 键 词：低强度超声诱导微泡空化 凝血酶 VX2肿瘤 激光消融 

分 类 号：R445.1[医药卫生—影像医学与核医学] R735.7[医药卫生—诊断学]