Delius M, Denk R, Berding C, Liebich H G, Jordan M, Brendel W
Institute for Surgical Research, University of Munich, Federal Republic of Germany.
Ultrasound Med Biol. 1990;16(5):467-72. doi: 10.1016/0301-5629(90)90169-d.
Shock waves are known to generate cavitation in vitro. In vivo, extracorporeal shock waves may cause haemorrhages in tissues. Two types of changes were detected by conventional, real-time B-scan ultrasound when shock waves were administered to 5 piglet livers in vivo: transient changes consisting of bright signals in intrahepatic branches of the portal vein and tributaries of the hepatic vein, presumed to originate from gas bubbles, and stationary changes consisting of brightening of the area along the long axis of the high pressure field, presumed to indicate an increased number of gas-filled bubbles in this area. Transient changes appeared from the start of shock wave administration; bright signals were seen in liver vessels for several hundred microseconds before they were flushed away with the blood flow. Stationary changes appeared later, increased in intensity over several hundred shock waves and persisted for minutes after cessation of shock wave administration. Both types of signals were interpreted as direct evidence that lithotripter shock waves generated cavitation in vivo. Similar signals were received in the partly degassed water of the lithotripter tub. At autopsy of the piglets, focal intralobular haemorrhages and thrombi of portal veins were detected in the shock wave path. The occurrence of cavitation and tissue damage in the same gross area suggests that cavitation might be involved in the generation of tissue damage by shock waves.
已知冲击波在体外可产生空化现象。在体内，体外冲击波可导致组织出血。当对5只仔猪肝脏进行体内冲击波治疗时，通过传统实时B超扫描检测到两种变化：一种是短暂变化，表现为门静脉肝内分支和肝静脉属支内出现明亮信号，推测源于气泡；另一种是静态变化，表现为高压场长轴沿线区域变亮，推测表明该区域内充满气体的气泡数量增加。短暂变化在冲击波治疗开始时就出现；肝脏血管内可见明亮信号持续数百微秒，随后被血流冲走。静态变化稍后出现，在数百次冲击波作用下强度增加，在冲击波治疗停止后仍持续数分钟。这两种信号都被解释为体外冲击波碎石机在体内产生空化现象的直接证据。在碎石机水槽部分脱气的水中也接收到了类似信号。对仔猪进行尸检时，在冲击波路径上发现了小叶内局灶性出血和门静脉血栓。在同一大体区域出现空化现象和组织损伤表明，空化可能与冲击波导致的组织损伤有关。
