Oregon Health Sciences University, Eugene, Oregon 97401,USA.
Aesthet Surg J. 2011 May;31(4):429-34. doi: 10.1177/1090820X11405026.
High-intensity focused ultrasound (HIFU) has been applied clinically for the noninvasive treatment of pathological conditions in various organs for over 50 years; however, there are little data describing the use of thermal HIFU to ablate fat for body contouring and treatment of collagen-rich layers. A novel device under clinical investigation (LipoSonix; Medicis Technologies Corporation, Bothell, Washington) uses HIFU to eliminate unwanted adipose tissue.
The authors describe the results of HIFU treatment in a series of preclinical studies performed in a validated porcine model.
Preclinical research included in vivo treatment of the abdominal subcutaneous adipose tissue of swine with transcutaneous HIFU therapy. Endpoint analyses included thermocouple temperature data, full-body necropsy, local pathology and histology studies, clinical hematology, urinalysis, and blood chemistry parameters, including lipid panels.
The application of HIFU energy levels of 166 to 372 J/cm(2) generated tissue temperature approaching 70°C, which was restricted to the focal area (n = seven). Application of 68 and 86 J/cm(2) did not produce clinically-significant changes in serum liver function tests, free fatty acids, or cholesterol (n = eight). Gross examination of tissue from various organs showed no evidence of fat emboli or accumulation (n = two). Histology demonstrated well-preserved vasculature and intact nerve fibers within the HIFU focal area (n = three). Following treatment with 85.3 to 270 J/cm(2), normal healing response included the migration of macrophages into the damaged tissue and removal of disrupted cellular debris and lipids (n = 8).
In a preclinical swine model, the controlled thermal effect of HIFU appears to provide a safe and effective means for ablating subcutaneous adipose tissue.
高强度聚焦超声(HIFU)在过去的 50 多年中已在临床应用于治疗各种器官的病理状况,无需侵入性治疗;然而,几乎没有数据描述使用热 HIFU 消融脂肪以用于身体塑形和治疗富含胶原蛋白的层。一种正在临床研究中的新型设备(LipoSonix;Medicis Technologies Corporation,华盛顿州 Bothell)使用 HIFU 消除不需要的脂肪组织。
作者描述了在经过验证的猪模型中进行的一系列临床前研究中 HIFU 治疗的结果。
临床前研究包括对猪的腹部皮下脂肪组织进行经皮 HIFU 治疗。终点分析包括热电偶温度数据、全身尸检、局部病理学和组织学研究、临床血液学、尿液分析以及血液化学参数,包括脂质谱。
应用 166 至 372 J/cm²的 HIFU 能量水平可产生接近 70°C 的组织温度,该温度仅限于焦点区域(n = 7)。应用 68 和 86 J/cm²不会导致血清肝功能测试、游离脂肪酸或胆固醇发生临床显著变化(n = 8)。对来自各种器官的组织进行的大体检查未显示脂肪栓塞或积聚的证据(n = 2)。组织学显示在 HIFU 焦点区域内血管和完整的神经纤维保持完好(n = 3)。在用 85.3 至 270 J/cm²进行治疗后,正常的愈合反应包括巨噬细胞迁移到受损组织中,以及清除破坏的细胞碎片和脂质(n = 8)。
在临床前猪模型中,HIFU 的受控热效应似乎为消融皮下脂肪组织提供了一种安全有效的方法。