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中华医学超声杂志（电子版）

中华医学超声杂志（电子版） ›› 2018, Vol. 15 ›› Issue (04) : 313 -318. doi: 10.3877/cma.j.issn.1672-6448.2018.04.015

所属专题： 文献；

基础研究

低频超声联合微泡辐照增大对犬前列腺增生组织射频消融灶体积的影响
徐燕军1, 侯瑞1, 陆奇杰1, 张杨1, 白文坤1, 胡兵1,†()   
  1. 1. 200233　上海交通大学附属第六人民医院超声医学科　上海超声医学研究所
  • 收稿日期:2017-02-15 出版日期:2018-04-01
  • 通信作者: 胡兵
  • 基金资助:
    国家自然科学基金(81271597)

Experimental study on increasing the volume of radiofrequency ablation of canine benign prostatic hyperplasia by low frequency ultrasound irradiation

Yanjun Xu1, Rui Hou1, Qijie Lu1, Yang Zhang1, Wenkun Bai1, Bing Hu1,†()   

  1. 1. Department of Ultrasound in Medicine, Shanghai Jiao Tong University Affiliated Sixth People′s Hospital, Shanghai Institute of Ultrasound in Medicine, 200233, Shanghai, China
  • Received:2017-02-15 Published:2018-04-01
  • Corresponding author: Bing Hu
  • About author:
    Corresponding author: Hu Bing, Email:
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引用本文：

徐燕军, 侯瑞, 陆奇杰, 张杨, 白文坤, 胡兵. 低频超声联合微泡辐照增大对犬前列腺增生组织射频消融灶体积的影响[J]. 中华医学超声杂志（电子版）, 2018, 15(04): 313-318.

Yanjun Xu, Rui Hou, Qijie Lu, Yang Zhang, Wenkun Bai, Bing Hu. Experimental study on increasing the volume of radiofrequency ablation of canine benign prostatic hyperplasia by low frequency ultrasound irradiation[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2018, 15(04): 313-318.

目的

评估低频超声辐照犬前列腺增生组织对射频消融灶大小的影响。

方法

实验犬共9只，分为3组（每组各3只），对犬前列腺行射频消融术，实验组消融术前行低频超声辐照，对照组仅行射频消融术或仅行低频超声辐照；术后即刻行经直肠前列腺常规超声检查、超声造影及磁共振增强检查。低频超声辐照加射频消融组与仅行射频消融术的对照组的增强磁共振成像前列腺消融灶体积的比较采用t检验，低频辐照前造影剂达峰时间、曲线下面积与低频辐照比较采用配对t检验。

结果

低频超声辐照后即刻超声造影显示，前列腺内造影剂达峰时间缩短，最大强度较辐照前减低，且造影剂持续时间变长，辐照后造影剂达峰时间由（28.55±10.88）s缩短至（14.81±5.15）s，差异有统计学意义（t=2.796，P=0.0189），时间-信号强度曲线曲线下面积由（2046.56±424.66）dB s缩小至（1454.82±458.12）dB s，差异有统计学意义（t=2.32，P=0.0427）。超声造影及增强磁共振均能准确评价前列腺射频消融灶大小。实验组消融后磁共振增强图像显示实验组消融灶体积为（1.27±0.21）cm3，仅行射频消融术的对照组消融灶体积为（0.73±0.18）cm3，差异有统计学意义（t=3.382，P=0.0277）；而仅行低频超声辐照的犬前列腺未出现消融灶。

结论

低频超声联合微泡辐照能有效阻断增生前列腺组织内血流灌注量，联合射频消融治疗能有效增大消融灶体积。

关键词: 超声检查, 前列腺增生, 消融技术
Objective

To evaluate the effect of low frequency ultrasound on the volume of the radiofrequency ablation lesion in canine hyperplasia prostate tissue.

Methods

A total of 9 experimental dogs were divided into three groups (3 in each group). Radiofrequency ablation was performed on the canine prostates. Low-frequency ultrasound was performed before the ablation of the experimental group. Radiofrequency ablation or low-frequency ultrasound was performed only in the control groups. Then all experiment animals underwent routine rectal examination, contrast-enhanced ultrasonography and MRI. The volume of prostate ablation lesions in enhanced magnetic resonance imaging was compared between the low-frequency ultrasound irradiation plus radiofrequency ablation group and the control group with radiofrequency ablation only. Statistical analysis was performed using the t-test to compare the differences between groups.

Results

Contrast enhanced ultrasonography (CEUS) performed immediately after low-frequency ultrasound irradiation showed that the time to peak of intra-prostatic contrast agent shortened, the maximum intensity decreased compared with those before irradiation [(28.55±10.88) s vs (14.81±5.15) s, t=2.796, P=0.0189], and the contrast agent duration increased [(2046.56±424.66) dB s vs (1454.82±458.12) dB s], the difference was statistically significant (t=2.32, P=0.0427). CEUS and MRI can accurately evaluate the size of the prostate radiofrequency ablation. The ablation volume of the experimental group after ablation was (1.27 ± 0.21) cm3 in the experimental group, while the volume of the ablation group in the control group was (0.73±0.18) cm3, and the difference was statistically significant (t=3.382, P=0.0277); however, the other group which were only exposed to low-frequency ultrasound did not show lesions.

Conclusion

Low frequency ultrasound irradiation can effectively block the blood flow in proliferative prostatic tissue, and combined with radiofrequency ablation can effectively increase the volume of ablation.

Key words: Ultrasonography, Prostatic hyperplasia, Ablation techniques
图1 低频超声辐照犬前列腺的数码照片。图中所示为低频超声探头与犬前列腺体表投影点
图2~5 低频超声联合微泡辐照前后犬前列腺超声造影图和造影图像分析。图2为低频超声辐照前造影图像；图3为低频超声辐照前TIC曲线；图4为低频超声辐照后造影图；图5为低频超声辐照后TIC曲线
图6 消融即刻犬前列腺横断面超声造影图像。红色圆圈内为消融区域，蓝色圆圈内为前列腺囊肿
图7~9 消融术后犬前列腺横断面增强MRI图像。图7为MRI上消融区呈T1WI不均匀高信号；图8为T2WI混杂信号；图9为增强消融灶内未见明显强化，周围组织强化明显
图10 犬前列腺消融灶大体观。红色箭头指消融灶，黑色箭头指充血带，可见凝固性坏死区、充血带及正常组织，蓝色圆圈内为前列腺囊肿
图11 犬前列腺消融灶病理图像。红色虚线内为凝固性坏死区，蓝色虚线内为充血带（HE ×40）
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