Humphries Alexander, Lister Tom S, Wright Philip A, Hughes Mike P
Centre for Biomedical Engineering, School of Engineering, University of Surrey, Guildford, Surrey GU2 7XH, United Kingdom.
Lasers Surg Med. 2013 Feb;45(2):108-15. doi: 10.1002/lsm.22107. Epub 2012 Dec 31.
Q-switched laser therapy is commonly used for the removal of tattoos. However, despite ever increasing demand for this intervention, a better understanding of the mechanisms that result in pigment reduction is required in order to optimise outcomes and reduce the number of treatment episodes.
A finite element analysis computer simulation was developed to model the fragmentation response of ink granules during irradiation of a professional black tattoo using a Q-switched Nd:YAG laser. Thermal and acoustic mechanisms were considered, allowing the optimal laser settings to be predicted throughout the course of treatment. Changes in the thermal properties of the ink during heating were taken into account to improve the reliability of the results obtained.
The simulated results are in close agreement with clinical observations. Thermal fragmentation was shown to be the dominant mechanism in pigment reduction when using a 6 nanoseconds pulse at 1,064 nm. In order to provide maximum clearance whilst maintaining acceptable levels of tissue thermal damage, later treatments were shown to benefit from higher fluence levels than initial treatments. Larger spot diameters were also preferable throughout the course of treatment.
The results from the simulation build upon previous work carried out in the field, applying ink thermal coefficients which vary with temperature for the first time. These results compliment clinical knowledge, suggesting that a proactive increase in fluence during a course of treatments is likely to improve the response to laser therapy.
调Q激光疗法常用于去除纹身。然而,尽管对这种干预措施的需求不断增加,但为了优化治疗效果并减少治疗次数,仍需要更好地理解导致色素减少的机制。
开发了一种有限元分析计算机模拟,以模拟使用调Q钕:钇铝石榴石激光照射专业黑色纹身时墨水颗粒的破碎反应。考虑了热学和声学机制,从而能够在整个治疗过程中预测最佳激光设置。加热过程中墨水热性能的变化也被考虑在内,以提高所得结果的可靠性。
模拟结果与临床观察结果高度一致。当在1064纳米波长下使用6纳秒脉冲时,热破碎被证明是色素减少的主要机制。为了在保持可接受的组织热损伤水平的同时提供最大清除率,后期治疗显示比初始治疗受益于更高的能量密度水平。在整个治疗过程中,较大的光斑直径也更可取。
该模拟结果基于该领域之前的工作,首次应用了随温度变化的墨水热系数。这些结果补充了临床知识,表明在一系列治疗过程中主动提高能量密度可能会改善对激光治疗的反应。