本文選題：高強(qiáng)度聚焦超聲　切入點(diǎn)：帽式消融　出處：《重慶醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：研究背景:高強(qiáng)度聚焦超聲(High intensity focused ultrasound,HIFU)作為一種新型的微無(wú)創(chuàng)腫瘤治療方法,以其不開(kāi)刀、不流血、不良反應(yīng)少等特點(diǎn),逐漸被大眾認(rèn)可,成為眾多腫瘤的替代治療方式之一。然而,由于傳統(tǒng)HIFU采用的“點(diǎn)-線-面-體”的輻照方式,消融過(guò)程復(fù)雜的同時(shí)也存在腫瘤內(nèi)部能量重疊,導(dǎo)致過(guò)度消融,能量浪費(fèi),降低了治療效率。加之超聲波的衰減、HIFU本身的技術(shù)限制,以及部分腫瘤血供豐富、體積大、位置深等因素,HIFU完整“切除”腫瘤所需時(shí)間較長(zhǎng),縮短治療時(shí)間又會(huì)導(dǎo)致組織殘留。這些因素制約著HIFU技術(shù)的進(jìn)一步推廣和發(fā)展。增效相關(guān)的研究多從改變聲學(xué)環(huán)境的角度推進(jìn),改進(jìn)消融方法方面的研究較少�；诔暤姆瓷�、折射等物理特性,本文從改進(jìn)消融方法學(xué)的角度提出了帽式消融,以互成夾角的兩個(gè)面促進(jìn)超聲能量向帽式結(jié)構(gòu)內(nèi)部聚集,減少能量向周圍正常組織擴(kuò)散的同時(shí)也減少了內(nèi)部能量的過(guò)度重疊,從而減少能量浪費(fèi),增效HIFU治療。研究目的:探討HIFU帽式消融在離體及活體實(shí)驗(yàn)中的可行性,對(duì)比不同參數(shù)組合下帽式消融的消融效果,尋找最優(yōu)消融方法,增效HIFU治療。材料與方法:實(shí)驗(yàn)分為離體牛肝及活體兔肝兩部分。離體實(shí)驗(yàn)中,通過(guò)改變兩個(gè)輻照面間的夾角、輻照順序,得到不同參數(shù)組合下的凝固性壞死。同時(shí),將帽式消融模式與傳統(tǒng)消融模式作對(duì)照,對(duì)比兩種消融模式的消融效果。將得出的結(jié)論應(yīng)用于活體兔肝中,驗(yàn)證其在活體中的可行性。消融結(jié)束后將肝臟組織切片,行TTC染色,觀察凝固性壞死形態(tài),計(jì)算凝固性壞死體積及能效因子,對(duì)比不同參數(shù)及條件下的消融效果。結(jié)果:1、離體及活體實(shí)驗(yàn)中,各組均形成肉眼及鏡下可見(jiàn)的凝固性壞死,壞死體積遠(yuǎn)大于輻照區(qū)體積;2、改變輻照夾角后形成的凝固性壞死的形態(tài)差異顯著,但凝固性壞死體積差異無(wú)統(tǒng)計(jì)學(xué)意義;3、不同輻照順序形成的凝固性壞死體積有明顯差異;4、一定條件下,帽式消融模式可較傳統(tǒng)消融模式縮短消融時(shí)間,減少總能量消耗,提高輻照效率。結(jié)論:帽式消融模式在離體及活體中均具有可行性。同時(shí),一定條件下,帽式消融模式可較傳統(tǒng)消融模式實(shí)現(xiàn)更高效的消融。
[Abstract]:Background: high intensity focused ultrasound (HIFU), as a new type of microinvasive tumor therapy, has been gradually accepted by the public because of its characteristics of no operation, no bleeding, few adverse reactions and so on. However, because of the point, line, plane and body irradiation mode adopted by traditional HIFU, the process of ablation is complicated and the internal energy overlaps, which leads to excessive ablation and energy waste. It reduces the therapeutic efficiency. In addition, the attenuation of ultrasound and the technical limitation of HIFU itself, as well as some factors such as abundant blood supply, large volume, deep position and so on, take a long time to "remove" the tumor intact. Shortening treatment time can lead to tissue residue. These factors restrict the further development of HIFU technology. Based on the physical characteristics of ultrasound, such as reflection and refraction, this paper proposes a cap ablation method to improve the ablation methodology, which promotes the ultrasonic energy to gather into the cap structure with two sides of mutually formed angles. Reducing the diffusion of energy to the surrounding normal tissue and reducing the excessive overlap of internal energy, thus reducing energy waste and enhancing HIFU therapy. Objective: to explore the feasibility of HIFU hat ablation in both in vitro and in vivo experiments. To compare the ablation effect of cap ablation with different parameters, to find the best ablation method and to enhance HIFU treatment. Materials and methods: the experiment was divided into two parts: bovine liver in vitro and rabbit liver in vivo. In vitro, the angle between the two irradiated surfaces was changed. The coagulation necrosis was obtained in different parameter combinations. The ablation effect of the two ablation models was compared with that of the traditional ablation model. The conclusions were applied to the living rabbit liver. After ablation, the liver tissue was sectioned and stained with TTC, and the coagulative necrosis was observed, the volume of coagulation necrosis and the energy efficiency factor were calculated. Results: in vitro and in vivo experiments, coagulation necrosis was observed in the naked eye and in vivo. The necrotic volume was much larger than that of the irradiated area, and there was significant difference in the morphology of the coagulant necrosis after changing the angle of irradiation. However, there was no significant difference in coagulation necrosis volume between different irradiation sequences. Under certain conditions, the cap ablation mode could shorten the ablation time and reduce the total energy expenditure compared with the traditional ablation mode. Conclusion: cap ablation is feasible in both in vitro and in vivo. At the same time, cap ablation is more efficient than traditional ablation under certain conditions.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R730.5;R454.3

【參考文獻(xiàn)】

相關(guān)期刊論文 前2條

1 王蕭峰;章東;屠娟;;Optison和SonoVue超聲造影劑的瞬態(tài)空化閾值測(cè)量(英文)[J];南京大學(xué)學(xué)報(bào)(自然科學(xué)版);2012年05期

2 Hitoshi Maruyama;Masaharu Yoshikawa;Osamu Yokosuka;;Current role of ultrasound for the management of hepatocellular carcinoma[J];World Journal of Gastroenterology;2008年11期

相關(guān)博士學(xué)位論文 前1條

1 計(jì)曉娟;微泡改變組織聲環(huán)境提高HIFU治療效率的初步研究[D];重慶醫(yī)科大學(xué);2006年

相關(guān)碩士學(xué)位論文 前1條

1 張婷;基于安全條件的HIFU聯(lián)合微泡增強(qiáng)山羊肝臟損傷的聲功率-SonoVue劑量的組合研究[D];重慶醫(yī)科大學(xué);2008年

，

本文編號(hào)：1621175