Oraevsky A A, Jacques S L, Esenaliev R O, Tittel F K
Department of Electrical and Computer Engineering, Rice University, Houston, Texas 77251-1892, USA.
Lasers Surg Med. 1996;18(3):231-40. doi: 10.1002/(SICI)1096-9101(1996)18:3<231::AID-LSM3>3.0.CO;2-T.
It is desirable for laser microsurgical procedures to remove tissue accurately and with minimal thermal and mechanical damage to adjacent non-irradiated tissues. Pulsed laser ablation can potentially remove biological tissue with microprecision if appropriate irradiation conditions are applied. The major goal of this study was to determine whether laser ablation is possible at temperatures below 100 degrees C. Another aim was to test thermoelastic and recoil stress magnitudes and to estimate their effects on phantom and biological tissue.
STUDY DESIGN/MATERIALS AND METHODS: Pulsed laser ablation of water (aqueous solution of potassium chromate) and water containing soft tissues (collagen gel and pig liver) irradiated under confined stress conditions was studied. The ablation mechanism and stages of the ablation process were determined based on time-resolved measurements of laser-induced acoustic waves with simultaneous imaging of the ablation process by laser-flash photography.
This study reveals the important role of tensile thermoelastic stress, which produces efficient cavitation that drives material ejection at temperatures substantially below 100 degrees C. Ablation thresholds for the aqueous solution, collagen gel, and liver were 20, 38, and 55 J/cm3, respectively, which correspond to temperature jumps of 5, 10, and 15 degrees C. Two distinct stages of material ejection were observed: (1) initial removal of small volumes of material due to the rupture of single subsurface bubbles, (2) bulk material ablation in the form of jets produced by intense hydrodynamic motions formed upon collapse of large bubbles after coalescence of smaller bubbles. The duration of material ejection upon short-pulse ablation may vary from microseconds to submilliseconds, and depended on the mechanical properties of materials and the incident laser fluence.
Nanosecond laser ablation of water, gels, and soft tissue under confined-stress conditions of irradiation may occur at temperatures below 100 degrees C. This ablation regime minimizes thermal injury to adjacent tissues and involves thermoelastic stress and recoil pressure magnitudes, which may be tolerated by tissues adjacent to an ablated crater.
激光显微手术需要精确地切除组织,同时对相邻未受照射的组织造成最小的热损伤和机械损伤。如果应用适当的照射条件,脉冲激光消融有可能以微精度切除生物组织。本研究的主要目标是确定在100摄氏度以下的温度下是否可以进行激光消融。另一个目的是测试热弹性和反冲应力的大小,并估计它们对模拟组织和生物组织的影响。
研究设计/材料与方法:研究了在受限应力条件下对水(铬酸钾水溶液)以及含有软组织(胶原凝胶和猪肝)的水进行脉冲激光消融。基于对激光诱导声波的时间分辨测量以及通过激光闪光摄影对消融过程的同步成像,确定了消融机制和消融过程的阶段。
本研究揭示了拉伸热弹性应力的重要作用,它能在远低于100摄氏度的温度下产生有效的空化现象,从而驱动物质喷射。水溶液、胶原凝胶和肝脏的消融阈值分别为20、38和55 J/cm³,这分别对应5、10和15摄氏度的温度跃升。观察到物质喷射有两个不同阶段:(1)由于单个亚表面气泡破裂导致少量物质的初始去除;(2)在较小气泡合并后大泡崩溃时形成的强烈流体动力运动产生的射流形式的大量物质消融。短脉冲消融时物质喷射的持续时间可能从微秒到亚毫秒不等,并且取决于材料的机械性能和入射激光能量密度。
在受限应力照射条件下,对水、凝胶和软组织进行纳秒激光消融可能在100摄氏度以下的温度下发生。这种消融方式可将对相邻组织的热损伤降至最低,并且涉及热弹性应力和反冲压力大小,而消融坑附近的组织可能能够承受这些。