高强度聚焦超声增效作用的实验研究  

Experimental Study of High Intensity Focused Ultrasound Sensitiz ation on Liver

作　　者：熊树华[1] 王智彪[2] 陈文直[2] 胡凯[2] 李发琪[2] 

机构地区：[1]江西省妇幼保健院肿瘤科,南昌市330006 [2]重庆医科大学医学超声工程研究所,重庆市400016

出　　处：《中国超声医学杂志》2003年第12期881-884,共4页Chinese Journal of Ultrasound in Medicine

基　　金：国家自然科学基金委重点项目( No.396 30 34 0 );国家"九五"重点科技攻关项目( No.96 - 90 5- 0 2 - 0 1)资助

摘　　要：目的 :通过探索肝脏碘油栓塞及其引起的病理变化对高强度聚焦超声 (HIFU)治疗剂量的影响 ,为HIFU增效理论实验和临床研究提供参考依据。方法 :43头山羊 ,分为病理观察组 10头和 HIFU辐照组 3 3头。前者再分为肝左动脉碘油栓塞组和栓塞结扎组 ,分别于碘油栓塞后 3 d、7d、14 d、2 1d和 2 8d观察其病理变化。后者又再分为对照组、碘油栓塞组和栓塞结扎组 ,经声强为 550 0 W/ cm2 的 HIFU辐照后测量并比较各组的 HIFU治疗剂量。结果 :山羊肝左动脉单纯碘油栓塞或栓塞结扎后 ,产生的肝脏病理变化主要表现为可逆的肝细胞气球样变性过程 ,但碘油栓塞结扎后引起的病理变化更为明显和严重 ,甚至可发生局灶性坏死。肝脏损伤深度为 3 0 mm时 ,对照组治疗剂量为 (16.6± 2 .72 ) J/ mm3 ,碘油栓塞结扎组为 (3 .8± 0 .96) J/ mm3 ,两组之间差异明显 (Ρ<0 .0 0 1)。损伤深度为 40 mm时 ,对照组治疗剂量为 (2 8.3± 6.3 7) J/ mm3 ,碘油栓塞组为 (11.2± 3 .46) J/ mm3 ,而碘油栓塞结扎组则为 (7.8± 1.74) J/ mm3,三组之间差别明显 (Ρ <0 .0 5)。肝脏碘油栓塞后 3 d的 HIFU治疗剂量为 (13 .56± 3 .462 ) J/ mm3,7d后为 (8.81± 0 .942 ) J/ mm3,两组之间差异明显 (Ρ <0 .0 5)。结论 :肝脏碘油栓塞或栓塞结扎后 ,Objective:To explore the influence of h epatic artery lipiodol embolization and pathological changes on HIFU destructive dosage of liver.Methods:Fourty-three goats were divided into pathologic al group which contained 10 goats and HIFU group which contained 33 goats.The f ormer were subdivided into left hepatic artery lipiodol embolization group or li piodol embolization and ligation group,and the hepatic pathology was examined af ter 3,7,14,21and 28 days of lipiodol embolization.The latter were subdivided int o three subgroups:the control group (group one),left hepatic artery lipiodol embolization group and the lipiodol embolization with ligation group.The left l obe of all animals were irradiated by HIFU (1 MHz,average acoustic intensity of 5 500 W/cm 2) with linear scaning mode.The destructive depth of liver were 3～4 cm under skin.The cover range were 30 mm×10 mm×10 mm.The space of scanning w as 5 mm.The times of every line scanning were 4～8,and were adjusted for induced hyperecho.Results:After lipiodol embolization and/or ligation, the h istological changes of the hepatic tissue characterized mainly reversible ballon -like degeneration.With HIFU radiation of a constant intensity of 5 500 W/cm 2,ablative dosage of liver 3 cm depth under the skin was 16 6±2 72 J/mm 3 f or group 1,3 8±0 96 J/mm 3 for group 3 and the difference was significant ( Ρ <0 001).The destructive dosage of liver 4 cm depth under the skin was 28 3 ±6 37 J/mm 3 for group one, 11 2±3 46 J/mm 3 for group 2 and 7 8±1 74 J/mm 3 for group 3.There were considerable differences among the three grou ps ( Ρ <0 05).The destructive dosages after 3 or 7 days of lipiodol embolizati on were 13.56±3 462 J/mm 3 and 8 81±0 942 J/mm 3,respectively( Ρ <005).Conclusions:Hepatic artery lipiodol embolization and/or li gation can decrease the destructive dosage of HIFU on liver.The results suggest that the HIFU ablating dosage can decreased by changing the acoustic chara cteristics of tissues.

关 键 词：高强度聚焦超声 肝脏碘油栓塞 治疗剂量 增效作用 病理特点 

分 类 号：R454.3[医药卫生—治疗学]