南方医科大学学报

南方医科大学学报 ›› 2016, Vol. 36 ›› Issue (10): 1352-.

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低剂量聚焦超声预辐照与微泡在高强度聚焦超声消融兔肝VX2移植瘤中的增效作用比较

张奕，杨超，邹建中，陈菲，欧霞，邹海蓉，王雁   

  • 出版日期:2016-10-20 发布日期:2016-10-20

Effect of low-dose focused ultrasound pre-irradiation versus microbubbles for enhancing high-intensity focused ultrasound ablation of VX2 hepatic tumor in rabbits

  • Online:2016-10-20 Published:2016-10-20

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摘要： 目的对比观察低剂量聚焦超声预辐照与微泡对高强度聚焦超声（HIFU）消融效果的影响，探讨低剂量预辐照的增效作 用。方法55只荷瘤兔随机分为3组：低剂量预辐照+HIFU消融组、微泡+HIFU消融组、单纯HIFU消融组，观察低剂量预辐照后 的病理变化，以及各组HIFU消融的时间、凝固性坏死体积、能效因子（EEF）、病理学变化及对声通道的影响等，并做统计学分 析。结果低剂量预辐照24 h后肿瘤细胞明显水肿，胞浆内出现大量空泡，肿瘤间质内血管淤血。低剂量预辐照+HIFU消融组 与微泡+HIFU消融组所用的消融时间明显短于单纯HIFU消融组，但在靶区产生凝固性坏死的体积增大，EEF值明显降低（P< 0.05），而两组间的差异无统计学意义。低剂量预辐照增效的有效性及稳定性不如微泡，但对声通道的安全性高于微泡。结论 低剂量预辐照具有与微泡相同的HIFU增效作用，同时具有无创、能集中作用于靶组织、安全性更高等优点，有可能成为一种新 的安全有效的HIFU增效方法。

Abstract: Objective To compare the effect of low-dose focused ultrasound pre-irradiation and microbubbles for enhancing the ablation effect of high intensity focused ultrasound (HIFU) on VX2 hepatic tumor in rabbits. Methods Fifty-five rabbits bearing VX2 hepatic tumor were randomly divided into low-dose pre-irradiation + HIFU ablation group, microbubbles+HIFU ablation group, and HIFU ablation group for corresponding treatments. The pathological changes in the tumors after low-dose irradiation, time for HIFU ablation, tumor volume with coagulative necrosis, energy efficiency factor (EEF), pathological changes in the ablated tumor, and sound channel of HIFU ablation were observed. Results Tumor cell edema, vacuolar changes in the cytoplasm and tumor interstitial vascular congestion were observed 24 h after low-dose pre-irradiation. The ablation time were significantly shorter, coagulative necrosis volume was larger, and EEF was lower in low-dose irradiation + HIFU ablation group and microbubbles+HIFU ablation group than in simple HIFU ablation group (P<0.05), but the differences between the former two groups were not significant. The effectiveness and stability of the synergistic effect of low-dose pre-irradiation were inferior to microbubbles, but the former ensured a better safety of the sound channel. Conclusion Low-dose irradiation has comparable synergistic effect in HIFU with microbubbles with such advantages as non-invasiveness, high concentration and good safety, and can be a potentially new method to enhance the efficiency of HIFU.