高强度聚焦超声联合微泡损伤山羊肝的增效性研究

摘要

目的 探讨超声造影剂SonoVue用于增强高强度聚焦超声(HIFU)损伤山羊肝组织的可行性.方法 南江黄羊15只,采用自身对照,分为HIFU治疗组(对照组)和HIFU联合造影剂治疗组(实验组).治疗深度30 mm,分别在声功率为150 W、250 W、350 W条件下对肝定点辐照15 S.辐照后24 h处死动物,解剖观察凝固性坏死情况,并作病理切片分析.结果 在相同声辐照参数下,实验组凝固性坏死发生率及凝固性坏死区域长、宽、厚、体积均明显大于对照组(P＜0.05),随功率增加实验组凝固性坏死体积增加幅度较对照组更明显,实验组能效因子(EEF)明显小于对照组.凝固性坏死区与正常肝组织分界清楚,且病理切片显示损伤为不可逆性,分界处可见大量空泡.结论 HIFU联合微泡造影剂能在山羊肝中形成完全的凝固性坏死,同时提高凝固性坏死的损伤率,增大凝固性坏死体积,提高HIFU治疗效率.%Objective To investigate the feasibility of enhancing therapeutic effects on goats' liver in vivo treated by high intensity focused ultrasound(HIFU)combined with microbubble contrast agent SonoVue.Methods Fifteen Nanjiang goats were adopted,own control was adopted in this study.One group received purely HIFU therapy(control group),another one was radiated with HIFU combined with SonoVue contrast agent(SonoVue group).The HIFU irradiating mode was dotted with 30 mm focal length and 150 W,250 W,350 W acoustic power respectively,and the exposure time was 15 s.Animals were sacrificed and dissected 24h later,and the sizes of necrotic region were measured.Specimens were collected for histological inspection.Results Under the same parameter of exposure,the maximum length,width,depth,and the mean volume of the tissue coagulated by HIFU in the SonoVue group were all significantly greater than those in control group(P＜0.05),the change of volume coagulated tissue was much more significant with the increase of the acoustic power.The energy effciency factor (EEF)of SonoVue group was significantly smaller than that of control group(P＜0.05).The demarcation line between the necrosis and normal region was clear and the necrosis was complete,no living cell.The boundary exist amount of bubbles.Conclusions The therapy of HIFU combined with microbubble eontrast agent can substantially enhance the biological effects of the treatment and improve the efficiency of HIFU therapy on goats liver.