Courivaud Frédéric, Kazaryan Airazat M, Lund Alice, Orszagh Vivian C, Svindland Aud, Marangos Irina Pavlik, Halvorsen Per Steinar, Jebsen Peter, Fosse Erik, Hol Per Kristian, Edwin Bjørn
The Intervention Centre, Oslo University Hospital, Oslo, Norway.
The Intervention Centre, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Medical Faculty, University of Oslo, Oslo, Norway.
Ultrasound Med Biol. 2014 Jul;40(7):1564-77. doi: 10.1016/j.ultrasmedbio.2014.02.007. Epub 2014 Apr 24.
The aim of this study was to investigate experimental conditions for efficient and controlled in vivo liver tissue ablation by magnetic resonance (MR)-guided high-intensity focused ultrasound (HIFU) in a swine model, with the ultimate goal of improving clinical treatment outcome. Histological changes were examined both acutely (four animals) and 1 wk after treatment (five animals). Effects of acoustic power and multiple sonication cycles were investigated. There was good correlation between target size and observed ablation size by thermal dose calculation, post-procedural MR imaging and histopathology, when temperature at the focal point was kept below 90°C. Structural histopathology investigations revealed tissue thermal fixation in ablated regions. In the presence of cavitation, mechanical tissue destruction occurred, resulting in an ablation larger than the target. Complete extra-corporeal MR-guided HIFU ablation in the liver is feasible using high acoustic power. Nearby large vessels were preserved, which makes MR-guided HIFU promising for the ablation of liver tumors adjacent to large veins.
本研究的目的是在猪模型中研究磁共振（MR）引导下高强度聚焦超声（HIFU）高效、可控地进行体内肝组织消融的实验条件，最终目标是改善临床治疗效果。在治疗后即刻（4只动物）和1周后（5只动物）检查组织学变化。研究了声功率和多次超声处理周期的影响。当焦点温度保持在90°C以下时，通过热剂量计算、术后MR成像和组织病理学观察，目标大小与观察到的消融大小之间具有良好的相关性。结构组织病理学研究显示消融区域存在组织热固定。在有空化现象时，会发生机械性组织破坏，导致消融范围大于目标范围。使用高声功率在肝脏中进行完全体外MR引导的HIFU消融是可行的。附近的大血管得以保留，这使得MR引导的HIFU在消融靠近大静脉的肝肿瘤方面具有前景。
