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中华医学超声杂志(电子版) ›› 2020, Vol. 17 ›› Issue (01) : 64 -69. doi: 10.3877/cma.j.issn.1672-6448.2020.01.012

所属专题: 文献

基础研究

无水乙醇和聚桂醇增强聚焦超声消融兔肝脏实验研究
丁彦军1, 李泞珊2, 乔伟2, 李佩倞2, 益磋2, 高文宏2, 米成嵘3,(), 刘政2   
  1. 1. 750001 宁夏医科大学;750001 宁夏医科大学附属自治区人民医院超声科
    2. 400037 重庆,陆军军医大学第二附属医院超声科
    3. 750004 重庆,宁夏医科大学总医院超声科
  • 收稿日期:2019-05-28 出版日期:2020-01-01
  • 通信作者: 米成嵘

Focused ultrasound combined with absolute ethanol or lauromacrogol for ablation of rabbit liver: an experimental study

Yanjun Ding1, Ningshan Li2, Wei Qiao2, Peijing Li2, Cuo Yi2, Wenhong Gao2, Chengrong Mi3,(), Zheng Liu2   

  1. 1. Ningxia Medical Univercity, Ningxia 750001, China
    2. Department of Ultrasound, People's Hospital of Autonmous Region Affiliated Ningxia Medical University, Ningxia 750001, China
  • Received:2019-05-28 Published:2020-01-01
  • Corresponding author: Chengrong Mi
  • About author:
    Corresponding author: Mi Chengrong, Email:
引用本文:

丁彦军, 李泞珊, 乔伟, 李佩倞, 益磋, 高文宏, 米成嵘, 刘政. 无水乙醇和聚桂醇增强聚焦超声消融兔肝脏实验研究[J/OL]. 中华医学超声杂志(电子版), 2020, 17(01): 64-69.

Yanjun Ding, Ningshan Li, Wei Qiao, Peijing Li, Cuo Yi, Wenhong Gao, Chengrong Mi, Zheng Liu. Focused ultrasound combined with absolute ethanol or lauromacrogol for ablation of rabbit liver: an experimental study[J/OL]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2020, 17(01): 64-69.

目的

探讨聚焦超声(FUS)的超声效应对无水乙醇(EA)、聚桂醇(LM)消融兔肝的协同作用。

方法

选用健康新西兰大白兔40只,随机分为5组:EA组、LM组、FUS+EA组、FUS+LM组,FUS组,每组8只。FUS焦点的平均声强(ISPTA)30.0 W/cm2,工作占空比50%。按分组对兔正常肝右叶根部给予消融处理,48 h后行超声造影分析并获取肝脏组织进行病理检查,测量消融灶大小和体积。采用Kruskal-Walis H秩和检验比较各组实验兔肝脏消融体积,进一步采用组间两两比较。

结果

各组的消融效果,差异有统计学意义(H=31.05,P<0.001)。FUS+EA组、FUS+LM组、EA组及LM组实现了对正常兔肝不同程度的消融,而FUS组没有产生任何微血管及病理损伤。进一步组间两两比较,FUS+EA组肝脏消融体积显著,差异有统计学意义(Z=-2.80、-2.82、2.84、5.57,P均<0.05);FUS+LM组、EA组、LM组和FUS组组间,差异无统计学意义(P>0.05)。

结论

FUS激励EA能够产生显著的协同效应,有效增大EA对兔肝的消融体积;FUS激励聚桂醇无协同效应。

Objective

To study the synergistic effect of focused ultrasound (FUS) combined with absolute ethanol (EA) and lauromacrogol (LM) in the ablation of rabbit liver.

Methods

Forty healthy New Zealand white rabbits were randomly divided into five groups: EA group, LM group, FUS plus EA (FUS+ EA) group, FUS plus LM (FUS+ LM) group, and FUS alone group. The right lobe of the normal liver of rabbits was then ablated. Forty-eight hours later, contrast-enhanced ultrasound (CEUS) was performed on the ablated lobes, and the size, shape, and boundary of the ablation lesions were observed. Liver tissue was obtained after angiography, and the volume of liver ablation was measured by drainage method. Kruskal-Walis H rank sum test was used to compare the ablation volumes among the experimental rabbits in each group, and between the groups.

Results

The ablation effects among different groups were statistically different (H=31.05, P<0.001). The FUS+ EA group, FUS+ LM group, EA group, and LM group achieved ablation of the normal rabbit liver to varying degrees, while the FUS group did not produce any microvascular or pathological damage. Further pairwise comparison showed that the FUS+ EA group had the most significant liver ablation (Z=-2.80, -2.82, 2.84, and 5.57, respectively, P<0.05). There was no significant difference between the FUS+ LM group, EA group, LM group, and FUS group (P>0.05).

Conclusion

FUS plus EA can produce significant synergistic effects and effectively enhance the ablation effect of EA alone on the rabbit liver in vivo. No synergistic effect is generated by FUS plus lauromacrogol.

表1 各组消融体积比较
图1 各组消融灶体积分布散点图
表2 各组消融灶超声造影长、宽、高及体积
图2 各组兔肝消融灶超声造影图像和大体标本图。图a、b为EA组消融灶超声造影和大体显示形态欠规则、边界清晰的病灶(箭头所示);图c、d为LM组消融灶超声造影和大体显示形态欠规则、边界清晰的病灶(箭头所示);图e、f为FUS+EA组消融灶造影和大体显示病灶范围较其他各组增大,形态不规则,边界清晰(箭头所示);图g、h为FUS+LM组消融灶,造影和大体显示边界清晰的病灶(箭头所示)
图3 消融灶病理图。图a(FUS组)未见明显病理性改变(HE染色×100);图b显示消融灶凝固性坏死区与正常肝组织间清晰的界限(箭头所示,HE ×100);图c显示消融灶周边见大量炎细胞浸润(箭头所示,HE ×200)
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