Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Minim Invasive Ther Allied Technol. 2022 Jan;31(1):89-93. doi: 10.1080/13645706.2020.1760301. Epub 2020 Jun 3.
Image-guided non-invasive high-intensity focused ultrasound (HIFU) has been gaining recognition in treating musculoskeletal tumors and desmoids. However, there is no consensus on the appropriate perioperative management for patients on ongoing anticoagulation who undergo HIFU ablation.
Image-guided HIFU treatment was performed in swine on an ongoing oral anticoagulation protocol ( = 5) in two treatment sessions seven days apart. On day one, a total of twenty locations were ablated, and on day eight, ten more muscle ablations were performed, and the animals were euthanized. Imaging, clinical examination, and histopathology were performed to investigate treated tissue for bleeding.
Imaging, clinical examination, and histopathology revealed either no bleeding or, in some samples, only small scattered cavities (0.2-2 mm in diameter) filled with blood.
Noninvasive HIFU ablation of muscle may not require a coagulation profile within normal limits.
在治疗肌肉骨骼肿瘤和硬纤维瘤方面，影像引导的非侵入性高强度聚焦超声（HIFU）已得到认可。然而，对于正在接受抗凝治疗且需要接受 HIFU 消融的患者，尚无关于适当围手术期管理的共识。
在持续口服抗凝方案（ = 5）下，对猪进行了影像引导的 HIFU 治疗，两次治疗间隔七天。第一天共消融了二十个部位，第八天又进行了十个肌肉消融，然后处死动物。进行影像学、临床检查和组织病理学检查，以调查治疗组织的出血情况。
影像学、临床检查和组织病理学检查显示无出血，或在一些样本中仅发现直径为 0.2-2 毫米的小散在腔隙充满血液。
肌肉的非侵入性 HIFU 消融可能不需要正常范围内的凝血谱。
