Splinter R, Tuntelder J R, Chuang C H, Thompson M, Littmann L, Svenson R H, Dezern K R, Tatsis G P
Laser and Applied Technologies Laboratory, Carolinas Medical Center, Charlotte, North Carolina 28203.
J Clin Ultrasound. 1994 May;22(4):221-9. doi: 10.1002/jcu.1870220403.
Endocardial coagulation lesions were created using transcatheter continuous-wave Nd:YAG laser irradiation. Ultrasound monitoring of thermal lesion dimensions was performed using 7.5-MHz and 10-MHz transducers directly from the epicardial surface in short-axis configuration (group A) or through the chest wall (group B). A total of 33 lesions were created in 10 dogs at energy levels ranging from 300 J to 1000 J. Mean histological lesion width (HW) compared with ultrasonically determined mean width (UW) showed that the differences (mean +/- standard deviation) in group A (UW - HW) was = 1.14 +/- 0.8 mm, which was not statistically significantly different from zero. In group B, (UW - HW) = 2.04 mm +/- 0.7 mm (p < .05), which was statistically significantly different from zero. Mean histological depth (HD) differentially related to ultrasound mean depth (UD) for group A and B combined showed (UD - HD) = -0.19 mm +/- 0.46 mm, not statistically significantly different from zero. The frequency distribution for width in group A showed magnitude of UW-HW > 3 mm in 32% of cases. In group B magnitude of UW-HW > 3 mm in 15%, whereas ultrasound width was larger than histology in 75% of the cases. For depth, magnitude of UD-HD > 3 mm in 15% of cases. With further refinement of the technique, ultrasonic tissue characterization may become a useful adjunct to monitoring lesion dimensions during transcatheter laser photocoagulation.
采用经导管连续波Nd:YAG激光照射制造心内膜凝固性损伤。使用7.5兆赫和10兆赫的换能器，以短轴配置直接从心外膜表面（A组）或通过胸壁（B组）对热损伤尺寸进行超声监测。在10只犬身上制造了总共33个损伤，能量水平范围为300焦耳至1000焦耳。将平均组织学损伤宽度（HW）与超声测定的平均宽度（UW）进行比较，结果显示A组（UW - HW）的差异（平均值±标准差）为1.14±0.8毫米，与零无统计学显著差异。在B组中，（UW - HW）= 2.04毫米±0.7毫米（p <.05），与零有统计学显著差异。A组和B组合并后，平均组织学深度（HD）与超声平均深度（UD）的差异显示（UD - HD）= -0.19毫米±0.46毫米，与零无统计学显著差异。A组宽度的频率分布显示，32%的病例中UW - HW > 3毫米。在B组中，15%的病例中UW - HW > 3毫米，而75%的病例中超声宽度大于组织学宽度。对于深度，15%的病例中UD - HD > 3毫米。随着该技术的进一步完善，超声组织特征分析可能成为经导管激光光凝过程中监测损伤尺寸的有用辅助手段。
