Delius M, Gambihler S
Institute for Surgical Research, Klinikum Grosshadern, University of Munich, FRG.
Digestion. 1992;52(1):55-60. doi: 10.1159/000200939.
During extracorporeal shock wave lithotripsy, changes in tissue echogenicity are observed by ultrasound. Their significance is not known. An experiment was performed in which 3,000 extracorporeal shock waves were applied under sonographic observation to the gallbladder wall of 6 dogs. No stones had been implanted, but transient shadows appeared simulating jumping stone fragments in the bladder. Echoes within the bladder lumen occurred in 3 dogs and were associated with hemorrhage into the lumen; in an additional ex vivo experiment, shock waves generated echoes in bile only after injection of a small amount of blood. In the liver, a transient increase in echogenicity was noted after a few shocks; it coincided with the region of tissue damage. Intense focal echoes occurred in the liver of 2 dogs at sites where a hematoma was found at autopsy. It is concluded that an increased focal echogenicity is an indicator of tissue damage by shock waves. The sonographic changes are thought to be caused by the transient generation of gas bubbles. The interaction of shock waves with gas bubbles is an established powerful mechanism which could explain the generation of tissue damage by shock waves.
在体外冲击波碎石术中，通过超声观察到组织回声性的变化。其意义尚不清楚。进行了一项实验，在超声观察下对6只狗的胆囊壁施加3000次体外冲击波。未植入结石，但出现了短暂的阴影，类似于膀胱内跳跃的结石碎片。3只狗的膀胱腔内出现回声，与腔内出血有关；在另一项离体实验中，仅在注入少量血液后，冲击波才在胆汁中产生回声。在肝脏中，几次冲击后观察到回声性短暂增加；这与组织损伤区域一致。在2只狗的肝脏中，尸检发现血肿的部位出现了强烈的局灶性回声。得出的结论是，局灶性回声性增加是冲击波造成组织损伤的一个指标。超声变化被认为是由气泡的短暂产生引起的。冲击波与气泡的相互作用是一种公认的强大机制，这可以解释冲击波造成组织损伤的原因。
