Arefiev A, Prat F, Chapelon J Y, Tavakkoli J, Cathignol D
INSERM, Lyon, France.
Ultrasound Med Biol. 1998 Sep;24(7):1033-43. doi: 10.1016/s0301-5629(98)00046-5.
Minimally invasive methods for the treatment of cancers, such as high-intensity focused ultrasound (HIFU) and high-energy shock waves (SW), have been proposed recently. Their feasibility for treatment of human cancer needs to be confirmed. A simplified model of isolated perfused pig liver that is close to the human liver in vivo has been proposed. The objective was to study the feasibility of deep focused tissue ablation with HIFU and SW in large organs approaching the size of the human liver. The model was demonstrated to be physiologically valid during the first 2 h of anoxic perfusion with a composite saline solution; arterial and portal pressure, enzymes, urea levels and bile secretion remained stable. It can simulate the major effects of perfusion and physical phenomena that occur in vivo during treatment. Histological analysis revealed no major changes. Previous results obtained in vivo in animal models at a depth of 2-3 cm were successfully reproduced and deeper lesion arrays at 4, 6, 8 and 9 cm from the surface were produced using the same principles. The depth of 9 cm from the liver surface is consistent with an extracorporeal treatment of most of the liver segments in man. Other applications of the model are proposed, particularly for the study of the role of interferences such as ribs and intestinal gas, blood perfusion and respiratory movements.
近年来，人们提出了一些治疗癌症的微创方法，如高强度聚焦超声（HIFU）和高能冲击波（SW）。它们治疗人类癌症的可行性需要得到证实。有人提出了一种离体灌注猪肝的简化模型，该模型在体内与人类肝脏相近。目的是研究在接近人类肝脏大小的大器官中，用HIFU和SW进行深部聚焦组织消融的可行性。该模型在复合盐溶液缺氧灌注的最初2小时内被证明具有生理有效性；动脉压、门静脉压、酶、尿素水平和胆汁分泌保持稳定。它可以模拟治疗过程中体内发生的灌注和物理现象的主要影响。组织学分析显示没有重大变化。此前在动物模型体内2-3厘米深度获得的结果成功再现，并且利用相同原理在距表面4、6、8和9厘米处产生了更深的损伤阵列。距肝脏表面9厘米的深度与人体大多数肝段的体外治疗一致。该模型还提出了其他应用，特别是用于研究肋骨和肠道气体、血液灌注及呼吸运动等干扰因素的作用。
