The advantages of ulthera assisted resection of carotid body tumors / 中华普通外科杂志

Objective:To evaluate the use of ulthera in carotid body tumor resectionMethods:From Jun 2004 to Jun 2019 at the First Hospital of China Medical University. Forty-three shamblin grade Ⅱ or Ⅲ patients were retrospectively assigned to ulthera assisted carotid body tumor resection (26 cases) and traditional carotid body tumor resection (17 cases).Results:In ulthera assisted group, the average tumor diameter was (4.0±0.6) cm, compared to (3.9±0.9) cm in traditional carotid body tumor surgery group, P=0.875. The operation time of the two group was respectively (117.6±39.8) min and (149.4±55.0) min ( P=0.005), blood loss (145.7±70.6) ml vs. (194.1±80.7) ml ( P=0.006), hospital stay was (16.8±7.5) d vs. (22.7±13.0) d ( P=0.017), and following-up period was between 6 and 180 months. One patient relapsed in ulthera assisted group. The postoperative complications occurred in 8 and 7 cases respectively. Conclusion:Ulthera assisted carotid body tumor resection helps shorten operation time, hospital stay and decrease intraoperative blood loss.

MR T2WI high signal rim sign affects immediate therapeutic responses of high intensity focused ultrasound ablation for uterine myoma / 中国介入影像与治疗学

Objective: To explore the impact of MR T2WI high signal rim sign (T2-rim sign) on the immediate efficacy of high intensity focused ultrasound (HIFU) in treatment of uterine myoma. Methods: Data of 360 uterine myoma patients treated with HIFU were retrospectively analyzed. The ablation effect was judged based on the percentage of non-perfusion area (NPV) of myoma after HIFU treatment and the volume of myoma before treatment (NPV%). According to the exist of preoperative MR T2-rim sign, the patients were divided into T2-rim sign group (with T2-rim sign) and no T2-rim sign group (without T2-rim sign). Univariate and multivariate Logistic analysis were performed to evaluate the impact of NPV%. Results: Immediately after ablation, contrast-enhanced ultrasound showed a marked reduction in blood supply of myoma, with 60 cases NPV%<75% and 300 cases NPV%≥75%, and significant differences of myoma location, irradiation time, treatment intensity, MR T2WI signal intensity and with or without T2-rim sign were found between them (all P<0.05). NPV% was correlated with MR T2WI signal intensity, T2-rim sign, irradiation time and treatment intensity (all P<0.05). The irradiation time, treatment intensity and T2-rim sign were independent risk factors for NPV% (all P<0.05). Compared with no T2-rim sign group, the irradiation time and treatment intensity of T2-rim sign group all increased (both P<0.05) and NPV% decreased (P<0.05). Conclusion: T2-rim sign is one of the impact factors of immediate therapeutic responses of HIFU ablation for uterine myoma. Uterine myoma patients with T2-rim sign are able benefit from HIFU.

Adequate rectal preparation reduces hospital admission for urosepsis after transrectal ultrasound - guided prostate biopsy

ABSTRACT Objectives: Previous studies have compared infectious outcomes on the basis of whether rectal preparation was performed; however, they failed to evaluate the quality of each rectal preparation, which may have led to confounding results. This study aimed to compare hospitalizations for urosepsis within 1 month after transrectal ultrasound-guided prostate biopsy between patients with adequate and traditional rectal preparations. Materials and Methods: Between January 2011 and December 2016, a total of 510 patients who underwent transrectal ultrasound - guided prostate biopsy at our institutions and were orally administered prophylactic antibiotics (levofloxacin) were included. Two rectal preparations were performed: (1) adequate rectal preparation confirmed by digital rectal examination and transrectal ultrasound (Group A, n = 310) and (2) traditional rectal preparation (Group B, n = 200). All patient characteristics were recorded. A logistic regression model was used to assess the effects of the two different rectal preparations on urosepsis, adjusted by patient characteristics. Results: There were a total of three and nine hospitalizations for urosepsis in Groups A and B, respectively. Differences in the demographic data between the two groups were insignificant. Logistic regression showed that adequate rectal preparation before biopsy significantly decreased the risk for urosepsis after biopsy (adjusted odds ratio: 0.2; 95% confidence interval: 0.05 - 0.78; P = 0.021). Conclusions: Adequate rectal preparation could significantly reduce hospitalizations for urosepsis within 1 month after transrectal ultrasound-guided prostate biopsy. The quality of rectal preparation should be evaluated before biopsy. If adequate rectal preparation is not achieved, postponing the biopsy and adjusting the rectal preparation regimen are suggested.

Relationship of therapeutic effect of uterine fibroids with different intraprocedural thermal parameters during MR-guided high-intensity focused ultrasound ablation / 中国介入影像与治疗学

Objective To explore the relationship of therapeutic effect of uterine fibroids with different intraprocedural thermal parameters during MR-guided high-intensity focused ultrasound (HIFU) ablation.Methods Totally 31 patients with uterine fibroids underwent MR scanning.Thermometry obtained during the treatment was used to create temperature curves.Matlab software was used to analyze the temperature curve to generate several parameters,including heating slope,decay slope,area under heating curve (AUC),heating time,max temperature and time to peak.Spearman correlation test was used to observe the relationship between the shrinkage rate of uterine fibroids 6 months after ablation and the intraprocedural thermal parameters of ablation.Results Six months after ablation,the fibroid volume shrinkage rate was (39.43±27.01) ％.The temperature curve showed the mean heating slope was (0.97±0.84)℃/s,the mean decay slope was (-0.56±0.39)℃/s,the mean AUC was (2 240.03±455.93)℃ · s,the mean heating time was (28.34±12.88)s,the mean max temperature was (47.01±4.63)℃,while the mean time to peak was (22.79±9.47)s.The decay slope showed positive correlation with volume shrinkage rate 6 months after treatment (rs =0.473,P =0.007).ConclusionSlower postsonication temperature decay rate predicts better therapeutic effect of MR-guided HIFU ablation.

Observation on pregnancy outcomes after high intensity focused ultrasound ablation therapy in patients with adenomyosis / 重庆医学

Objective To investigate the influence of high intensity focused ultrasound(HIFU) ablation therapy on pregnancy outcomes in the patients with adenomyosis(AM).Methods Twenty patients with AM and successful pregnancy after HIFU ablation in Chongqing Haifu Hospital from April 2011 to February 2016 were selected.Their pregnancy and delivery situation were retrospectively analyzed.Results After HIFU treatment,the symptoms of dymenorrhea and menorrhagia were significantly improved compared with before operation(P＜0.05).The average fertilization time after HIFU was(8.75 ± 6.23) months,among them 11 cases succeeded in delivery,5 cases had spontaneous abortion,1 case was ectopic pregnancy,1 case took artificial abortion and 2 cases were still in pregnant period all cases had no uterime rupture during pregnant or delivery period.Neonateswere healthy.Conclusion HIFU ablation is an effective mode for treating AM and can be used in the patients with AM and birth demand.

Prostate cancer volume estimations based on transrectal ultrasonography-guided biopsy in order to predict clinically significant prostate cancer

Tumor diameter is a reliable parameter to estimate tumor volume in solid organ cancers; its use in prostate cancer is controversial since it exhibits a more irregular pattern of growth. This study aimed to examine the association between the tumor volume estimations based on transrectal ultrasound (TRUS) guided biopsy results and the tumor volume measured on the pathological specimen.

Preliminary study on the relationship between the blood supply of rabbit liver VX2 tumor models and the HIFU / 中国医师杂志

Objectives To explore the effects of the blood supply extent on the temperature of target site of tumor and volume of coagulation necrosis (V),and to provide experimental evidence for further precise control of dosage of high intensity focused ultrasound (HIFU) and improve the efficiency of HIFU in the treatment.Methods Twenty-four rabbit liver VX2 tumor models were established and were divided into four groups:10 d group,15 d group,20 d group,no blood supply group (rabbits were put to death in the 10 d after the models were established).The same irradiation parameters of HIFU were used to irradiate the hepatic tumor tissue of every group,the real-time temperature of target site of tumor were measured,the software from temperature controller was used to plot the time-temperature curve (TTC),V was measured after HIFU.Residual tumor tissue was resected for pathological observation and microvascular density (MVD) determination.Results (1) Histopathological analysis showed that the extent of a tumor's blood supply followed the order 10 d group ＞ 15 d group ＞ 20 d group (P ＜ 0.01).(2)Tmax,T1,k1:betweengroups had no statistical difference among 10 d group,15 d group,20 d group (P ＞0.05),T T1,and k1 between three groups with no blood supply group had statistical difference (P ＜ 0.05).(3) k2:10 d group ＞ 15d group ＞ 20d group ＞ no blood supply group;T2:10d group ＜ 15d group ＜ 20d group ＜ no blood supply group;(4)V:10 d group ＜ 15 d group ＜ 20 d group ＜ no blood supply group.Conclusions The extent of a tumor's blood supply had a significant effect on the temperature-decrease phase but not on the temperature-increase phase during HIFU treatment.The more abundant blood supply of the tumor was,the faster heat abstraction after HIFU was;and the easier the tissue return to normal temperature,the smaller the volume of coagulation necrosis tissue were.

Clinical study of PEI combined with HIFU for treating unresectable middle and advanced stages of primary liver cancer / 重庆医学

Objective To investigate whether the percutaneous ethanol injection (PEI)under sedation and analgesia can in-crease the energy deposition and curative efficiency of the high intensity focused ultrsound(HIFU)in treating unresectable middle and advanced stages of primary liver cancer.Methods Thirty-six cases of clinically diagnosed unresectable middle and advanced sta-ges of primary liver cancer were randomly divided into the PEI+ HIFU group(combination group,n = 23)and the simple HIFU group (HIFU group,n=13);10mL of the mixture of 99.7% ethanol and iodized oil (9:1)was given by intratumoral injection at 30 min before ablation in the PEI+HIFU group,while 0.9% physiological saline 10mL was replaced in the simple HIFU group.The ablation energy efficiency factor(EEF)and irradiation time were compared between the two groups.Results The ablation EEF in the PEI+HIFU group and the simple HIFU group were (13.82+4.26)J/mm3 and (25.63+6.31)J/mm3 respectively,the PEI+HIFU group was significantly lower than the simple HIFU group (P <0.05);the irradiation time were (1 468.28+253.21)s and (2 352.56+463.34)s respectively;which in the PEI+ HIFU group was significantly shortened (P <0.05).Conclusion PEI can enhance the HIFU ablation energy deposition and improve the efficiency of HIFU for treating unresectable primary liver cancer.

Clinical value of 125I seeds implantation combined with high intensity focused ultrasound for the treatment of portal vein tumor thrombus from hepatocellular carcinoma / 中华核医学与分子影像杂志

Objective To investigate the clinical efficacy and feasibility of 125I seeds implantation combined with high intensity focused ultrasound (HIFU) for portal vein tumor thrombus (PVTF) from HCC.Methods Nineteen cases of PVTT from HCC (17 males,2 females;average age:50 years,stage:Ⅰ-Ⅲ)undergoing 125I seeds implantation combined with HIFU from March 2011 to October 2013 were retrospectively studied.The radioactivity of each 125I seed was 18.5 MBq and the matched peripheral dose was 90-120 Gy.HIFU parameters were set as follows:ultrasound wave frequency,0.85 mHz;output power,300-400 W;total treatment duration,33-70 min.During the follow-up of 3-24 months,the change of PVTT size,postoperative complications and survival rate were recorded.Kaplan-Meier method was used to analyze the survival rate.Results The treatment was successfully completed in all patients and no serious complications were observed.After 1 month of follow-up,the tumor thrombi shrank in all patients.Among 19 patients,9 achieved PR,4 SD,6 PD.The one-year and two-year survival rates were 47.4％ and 7.9％,respectively.The mean survival was 11.6±3.0 months (range:3-24 months).The median postoperative survival for stages Ⅰ,Ⅱ,Ⅲ was 13.5,7.0,4.0 months,respectively.Conclusion 125I seeds implantation combined with HIFU could be a safe and effective therapy for PVTT from HCC.

Clinical research of long-term efficacy of high intensity focused ultrasound in treating allergic rhinitis / 重庆医学

Objective To observe the long-term efficacy of nasal endoscopy-guided high intensity focused ultrasound (HIFU ) in the treatment of allergic rhinitis .Methods 300 patients with allergic rhinitis who failed in medication were randomly divided into the treatment group(n=162) and the control group(n=138) .The patients in the treatment group were accepted the nasal endosco-py-guided HIFU therapy ,while the patients in the control group were subjected to the hypothermy plasma ablation .The two groups were followed up after operation ,and the visual analogue scale(VAS) was employed to evaluate the therapeutic efficacy at postoper-ative 3 ,6 ,12 ,24 months .The saccharin tests were performed at the beginning and ending of treatment to assess the nasal mucocili-ary function in the patients of the two groups who voluntarily accepted the functional test of nasal cilia .Results After 2-week treat-ment ,nasal congestion ,sneezing ,runny nose ,nasal itching and other symptoms in the two groups were significantly relieved with no obvious complication .2-year follow-up demonstrated that the total effective rate in the treatment group was 61 .4% ,which was markedly higher than 50 .7% in the control group(P=0 .017) .The average saccharin clearance time of the treatment group (n=49) and the control group(n=39) were(464 ± 152)s and(738 ± 149)s ,respectively ,and their difference was statistical significant (P=0 .026) .Conclusion The long-term efficacy of HIFU treatment in allergic rhinitis is superior to that of hypothermy plasma abla-tion ,possesses less impacts on the nasal mucociliary function ,and is worthy of clinical promotion .

Opening of the blood-brain barrier through focused ultrasound in combination of drugs to treat glioma / 中华超声影像学杂志

Objective To evaluate the effectiveness of treating glioma in combination of two kinds of drugs by comparing the size of tumors and the survival time of different groups in rat glioma after targeted blood‐brain barrier (BBB) disruption by focused ultrasound under MRI‐guide. Methods The stereotaxis instruments and the 10 μl gas‐tight syringes were used to inject gliosarcoma cells into the targeted area of the brain in 40 male Sprague‐Dawley rats. The glioma‐bearing rats models were established. Rats were divided into 4 groups to receive different treatment :(1) no treatment (control, n = 8), (2) IV Avastin (Avastin only, n =10), (3) IV liposomal doxorubicin (DOX only, n =10), (4) IV Avastin and liposomal doxorubicin (Avastin+DOX, n =10). The SonoVue microbubbles and DOX or Avastin were injected into the tail vein respectively on the 12th day after implantation. The tumor size was measured by MRI on immediacy, once a week after targeted BBB disruption by focused ultrasound, and the life span in rat glioma was recorded. Results The average survival time of different groups in rat glioma was as follows :no treatment(17 ± 4)d, Avastin(20 ± 4)d, DOX(25 ± 5)d, DOX+ Avastin(40 ± 5)d. The tumor size after post‐treatment of different groups in rat glioma was as follows :no treatment(5 7.0 ± 4 3.0)mm, Avastin(4 3.0 ± 2 5.0)mm, DOX(4 1.2 ± 3 1.0)mm, DOX + Avastin(2. 20 ± 1. 30)mm. There was significant increased in average survival time and decreased in tumor size after a combination treatment DOX+ Avastin compared with other groups( P < 0 0.1). Conclusions The microbubble blasting by MRI‐guided focused ultrasound enhances the local tissue permeability and promotes the drug delivery of chemotherapy and anti‐angiogenesis locally in glioma‐bearing rats. Especially, the combination of two kinds of drugs has a synergism efficacy that may reduce tumor growth and increase survival time significantly after BBB disruption.

Dosimetry and efficacy of high intensity focused ultrasound in the treatment of pancreatic cancer / 中华肝胆外科杂志

Objective To study the efficacy and the safe dosage of high intensity focused ultrasound (HIFU) ablation in pancreatic cancer.Methods From November 2010 to May 2013,21 patients with advanced pancreatic cancer were treated by HIFU at the First Affiliated Hospital of Zhengzhou University.These patients who were randomly divided into two groups (10 and 11 patients respectively),were given a low-power (100～249 W) treatment and a high power (250 ～350 W) treatment.These two groups of 21 patients received a total of 25 times of HIFU treatment (3 patients received twice of low-power treatment,while 1 patient received twice of high-power treatment).The two groups were compared by analyzing the treatment parameters (average power,total treatment time,treatment total energy,treatment volume,etc.) and volume of tumour response as shown on postoperative imaging (CT or MRI) examinations.Also,the complications,degree of pain relief and survival were compared.The energy efficiency factor (EEF) and the ablation ratio were calculated.A preliminary study was conducted on the relationship of the ultrasound dose and the ablation effect of HIFU treatment for pancreatic cancer.Results (1) The EEF of the high-power group (≥250 W) and the low-power group (＜ 250 W) were (10.39 ± 5.71) J/mm3 and (21.62 ± 9.81) J/mm3,the former group was significantly lower than the latter group (P ＜0.05) ; the ablation ratio of the high-power group was higher than the low-power group,(91.52 ± 4.18)％ versus (51.59 ± 7.66)％ respectively,the difference was statistically significant (P ＜ 0.001).(2) The efficiency factor and the ablation volume for the HIFU treatment showed a linear trend,and both were negatively correlated (Pearson correlation coefficient r =-0.485,P ＜ 0.05).(3) There was no serious complication after the HIFU treatment.In the low-power group,six of ten patients were alleviated of his pain (60％) ; the CA19-9 decreased in four of ten patients after HIFU treatment (40％).In the high-power group,nine of eleven patients were significantly relieved of pain after treatment (82％),the CA19-9 decreased in five of nine patients after HIFU treatment (56％).(4) On Kaplan-Meier survival analysis,HIFU treatment of patients with pancreatic cancer,the median survival was 8 months and 9 months in the low-power group and high power group,respectively (Log-rank test x2 =0.05,P =0.944).Conclusion During HIFU treatment of patients with pancreatic cancer,if the ultrasound power was between 250 W and 350 W,there was a higher proportion of tumor ablation,but with no serious complications.Thus,this dose was safe.

Pain related and overall morbidity with TRUS guided prostate biopsy a prospective study

Objective To assess analgesia requirement after trans-rectal ultrasound guided prostate biopsy(TRUSBx) for appropriate counselling. Materials and Methods Prospectively, successive patients undergoing TRUSBx between July 2009 and November 2011 were given questionnaires prior to procedure. Standard 12-core TRUSBx under peri-prostatic block (10 mL of 1% lidocaine) and antibiotic prophylaxis (oral ciprofloxacin, intravenous gentamicin and metronidazole suppository) were performed. Pain perception was assessed using a Visual Analogue Score (VAS). Results Mean (range) age of the 405 patients was 67.3 years (48-88). Mean VAS during the procedure was 2.93 and 2.20 on reaching home. Mean maximum VAS for the cohort on day 1 and day 2 were 1.27 and 0.7 respectively. 140 (35%) were independent with some or minimal discomfort. 14 patients required assistance for some of their basic daily needs. 9 patients (2.2%) were hospitalised due to sepsis. 131 patients (32.4%) required additional oral analgesia following TRUSBx on days 0, 1 and 2. These patients were generally younger with a mean age for this group of 63.6 years (46-88). The difference in the mean age between those self-medicating and not was not statistically significant (p > 0.005). This group had mean VAS during the procedure of 4 and when patients reached home was 3.5. Mean maximum VAS on day 1 and 2 was 2.1 and 1.3 respectively. 11 patients required assistance from another adult. Conclusion A third of patients required self-medicated analgesia post-procedure. Age alone cannot be used as a criterion to identify patients who will subsequently require analgesia post-procedure, but a higher VAS during the procedure may be indicative. These patients must be counselled appropriately. .

The application of ultrasound visualization in instantly evaluation and supplement therapeutics in the treatment of uterine fibroids and adenomyosis with HIFU / 重庆医学

Objective To investigate the application of ultrasound visualization in instantly evaluation and supplement therapeu-tics in the treatment of uterine fibroids and adenomyosis with high intensity focused ultrasound (HIFU ) .Methods 57 patients with 67 uterine fibroids and 31 patients with 41 adenomyosis were treated with JC-200 HIFU treatment system and monitored the blood flow change in the lesion with B-ultrasound .Evaluated the curative effect with ablation ratio and ablation ratio after supplement therapeutics .Results The average ablation ratio of 57 uterine fibroids was(84 .6 ± 16 .1)% and the increased to(87 .0 ± 10 .7)% af-ter supplement therapeutics to 9 lesions with blood flow in the border of all .The changes were no significance(P>0 .05) .The aver-age ablation ratio of 31 adenomyosis was(62 ± 22 .7)% and increased to(74 ± 14 .7)% after supplement therapeutics to 11 lesions with blood flow in the border of all .The changes were statically significance(P<0 .05) .Conclusion Ultrasound visualization could be used to evaluate the area and extent of ablation with HIFU therapy ,it can clear lesions remaining parts and guiding the supple-ment therapeutics to improve the ablation ratio .Ultrasound visualization provided an evidence of therapeutics in the early period .

Localized scleroderma: assessment of the therapeutic response to phototherapy / Esclerodermia cutânea: avaliação da resposta terapêutica à fototerapia

BACKGROUND: Scleroderma is a chronic autoimmune disease characterized by progressive connective tissue sclerosis and microcirculatory changes. Localized scleroderma is considered a limited disease. However, in some cases atrophic and deforming lesions may be observed that hinder the normal development. Literature reports indicate phototherapy as a therapeutic modality with favorable response in cutaneous forms of scleroderma. OBJECTIVES: This study had the purpose of assessing the phototherapy treatment for localized scleroderma. METHODS: Patients with localized scleroderma were selected for phototherapy treatment. They were classified according to the type of localized scleroderma and evolutive stage of the lesions. Clinical examination and skin ultrasound were used to demonstrate the results thus obtained. RESULTS: Some clinical improvement was observed after an average of 10 phototherapeutic sessions. All skin lesions were softer at clinical palpation with scores reduction upon pre and post treatment comparison. The ultrasound showed that most of the assessed lesions presented a decrease in dermal thickness, and only five maintained their previous measure. Treatment response was similar regardless of the type of phototherapeutic treatment employed. CONCLUSIONS: The proposed treatment was effective for all lesions, regardless of the phototherapeutic modality employed. The improvement was observed in all treated skin lesions and confirmed by clinical evaluation and skin ultrasound.

FUNDAMENTOS: A esclerodermia é uma doença autoimune caracterizada pela esclerose progressiva do tecido conjuntivo e alterações da microcirculação. A forma cutânea é considerada uma doença autolimitada. No entanto, em alguns casos, ocorrem lesões atróficas, deformantes, que dificultam o desenvolvimento normal. Relatos da literatura apontam a fototerapia como uma modalidade terapêutica com resposta favorável nas formas cutâneas da esclerodermia. OBJETIVOS: Este trabalho teve como objetivo avaliar o tratamento da esclerodermia cutânea com fototerapia. MÉTODOS: Foram selecionados pacientes com diagnóstico de esclerodermia cutânea para o tratamento com fototerapia, os quais foram classificados de acordo com o tipo clínico e o estágio evolutivo das lesões. Utilizou-se o exame clínico e a ultrassonografia da pele como metodologia para demonstrar os resultados obtidos com o tratamento proposto. RESULTADOS: Foi observado o início da melhora clínica das lesões com média de 10 sessões de fototerapia. A palpação clínica mostrou amolecimento em todas as lesões estudadas, com redução nos escores de avaliação estabelecidos. No exame de ultrassom, a maioria das lesões avaliadas mostrou diminuição da espessura da derme, e apenas cinco mantiveram sua medida. Não se observou diferença na resposta ao tratamento de acordo com o tipo de fototerapia instituída. CONCLUSÕES: O tratamento proposto foi efetivo em todas as lesões, independentemente do tipo de fototerapia realizada. A melhora foi observada em todas as lesões tratadas e comprovada pela avaliação clínica e pelo exame de ultrassom da pele.

Experimental study of polymeric microcapsules with liquid perfluorocarbon enhancing high intensity focused ultrasound ablation of normal liver / 中华超声影像学杂志

ObjectiveTo study the optimal power of self-made polymeric microcapsules with liquid perfluorocarbon enhancing high intensity focused ultrasound (HIFU) ablation of normal bovine in vitro and the treatment efficacy of HIFU ablation of normal rabbit liver in vivo.Methods The experiment was divided into two parts:the first part was HIFU ablation of bovine in vitro:The bovine was injected different drugs before HIFU ablation to find the optimal power and treatment time.It was divided into four groups:①HIFU + 0.9％ NaCl(NACL) group; (② HIFU + poly( lactic-co-glycolic acid) (PLGA) group; ③ HIFU + perfluorohexane(PFH) group; ④ HIFU + PLGA + PFH group; The second part was HIFU ablation of normal rabbit liver.Similarly,It was also divided into four groups as above.Each group was undergone HIFU ablation with same parameters after ear vein injection of drug.Then the ultrasonographic changes and its value,and the actual situation of liver damage in target areas of each group were observed and compared before and after the ablation area.ResultsIn experiments of vitro bovine,gray scale changes and coagulation necrosis could be seen in the liver in group 2,3,4 with HIFU power of 150 W and treatment time of 2 s.In experiment of normal rabbit liver,the average gray-scale of group 3 and 4 were larger than that in group 1 and 2,the difference was statistically significant (P ＜0.001),and its gray change area gradually reduced with time elapsed.While there was no statistically significant difference between group 3 and 4 ( P ＞0.05).In pathological specimens,there was no significant liver damage in group 1 and 2.There was hemorrhagic necrosis and white coagulation necrosis in group 3 and 4.Conclusions The polymeric microcapsules with liquid perfluorocarbon can effectively enhance the efficacy of HIFU ablation and be used as a good synergist for HIFU.

Experiment study of Fe3O4-loaded polymer microspheres for combining with high-intensity focused ultrasound to damage breast cancer of rabbits / 中华超声影像学杂志

Objective To prepare the Fe3O4 loaded polymer microspheres(Fe3O4/PLGA),and to investigate the influence of Fe3O4/PLGA combined with high-intensity focused ultrasound (HIFU) on rabbits bearing breast tumor.Methods Double emulsion method were utilized to prepare the Fe3O4/PLGA.14 days after implantation of VX2 tumor in breast,32 rabbits were randomly divided into four equal groups.In group Ⅱ,Ⅲ,and Ⅳ,the rabbits received a percutaneous injection of 0.5 ml saline,PLGA,and Fe3O4/PLGA microcapsules solution into breast tumor at 3,6,9,12 dots,about 3 mm around the tumor respectively,and massaged for 1 min before receiving HIFU ablation,while HIFU group received HIFU ablation only.HIFU ablation parameters were the same:ablated-dot mode,acoustic power 150 W,exposure duration 5 s.After HIFU ablation,the volume of coagulative necrosis was calculated,HE staining,TEM and immunohistochemical examination of PCNA were performed to detect the structure changes of the targeted tissue caused by HIFU ablation.Results The volume of coagulative necrosis caused by HIFU ablation was substantially larger and the positive index of PCNA was lower in the necrotic region after the injection of Fe3O4/PLGA microcapsules compared to the group without injection agents,the group of saline and the group of pure PLGA microspheres under the same irritation(P ＜0.05).Pathological examination demonstrated the targeted tissue was destroyed severely,Fe3O4 nanoparticles were seen depositing in residual tumor cells under TEM.Conclusions The self-made Fe3O4/PLGA microspheres can effectively enhanced the biomedical effect of HIFU surgery on rabbits bearing VX2 breast tumor.

Multi-functional ultrasound contrast agents for in vitro ultrasound/MR dual-mode imaging and high-intensity focused ultrasound synergism / 中华超声影像学杂志

Objective To prepare the multi-functional ultrasound contrast agents,which were investigated for ultrasound(US)/MR dual-mode imaging and high-intensity focused ultrasound(HIFU)synergism in vitro.Methods Double emulsion method was used to prepare the superparamagnetic iron oxide(SPIO)-loaded PLGA microcapsules(s-PLGA),and its morphology,size,Fe3O4 loading capacity were assessed.Then,the prepared s-PLGA microcapsules with different concentrations were applied to perform ultrasound and MR imaging in vitro.In addition,the degassed bovine liver in vitro was directly injected into 200 μl s-PLGA in saline(0.5 mg Fe/ml)just before HIFU ablation,the saline(200 μl)and pure PLGA (200 μl)were employed for control.After HIFU ablation,the volume of coagulated tissue irradiated by HIFU was calculated.Results The s-PLGA microcapsules were observed with regular spherical morphology and its average size was(885.6 ± 133.2)nm.In vitro,the s-PLGA showed hyperechogenicity in US imaging and MR negatively enhanced effeet in T2WI,the volume of coagulated tissue irradiated by HIFU after local injection of s-PLGA was larger than that of saline and pure PLGA(P＜0.05).Conclusions The prepared s-PLGA microcapsules are successfully acted as dual-mode biological imaging contrast agents for ultrasound and MR imaging and HIFU synergism in vitro.

High-intensity focused ultrasound with submicrobubbies to damage rabbit breast VX2 tumors / 中华超声影像学杂志

Objective To observed the effect of high-intensity focused ultrasound (HIFU) in combination of submicrobubble on ablation of breast tumor VX2 in rabbits.Methods Submicrobubble was prepared,and the appearance,distribution,diameter,and zeta potential were measured.The rabbits were injected with the tumor tissue suspension in bilateral breast tissues.HIFU(150 W,120 W,5 s,3 s) combined with submicrobubble to damage rabbit breast VX2 tumors.The coagulation necrosis was assessed by HE staining.The grayscale changes of the target area before and after HIFU irradiation were recorded automatically by computer.Results The diameter of the submicrobubble was 498.9 nm on average.HE staining showed the area of coagulation necrosis was significantly larger in the HIFU + submicrobubble group than the HIFU + PBS group.The injury range of 150 W irradiation was larger than that of 120 W irradiation,given the same irradiation time.The injury range of 5 s irradiation was larger than that of 3 s irradiation,given the same irradiation strength.The gray scale change in the target area was significantly higher in the HIFU + submicrobubble group than the HIFU + PBS group.Conclusions The submicrobubble exhibited sound imaging performance,and it can be use in the ultrasound therapeutics in the future.

High-frequency ultrasound guided paracentesis for the treatment of perianal and perirectal abscess / 中国介入影像与治疗学

Objective To explore the method and therapeutic effect of high-frequency ultrasound guided paracentesis for the treatment of perirectal abscess.Methods Thirty-three patients with perirectal abscess were treated under the guidance of high-frequency ultrasound.Results All 33 patients were treated successfully,the curative rate was 100%.Six patients were treated 3 times,6 patients were treated twice and 21 patients were treated once.Conclusion High-frequency ultrasound guided paracentesis for the treatment of perirectal abscess has the superiorities of little distress,rapid therapeutic effect without complications,worthy Of further clinical application.