高强度聚焦超声的临床应用

高强度聚焦超声是近几年发展起来的一种新的非介入性肿瘤治疗技术,临床应用越来越广,文章就其在不同肿瘤如前列腺癌、肝癌、胰腺癌、子宫肌瘤等治疗中的应用及进展进行评述。     

相控阵高强度聚焦超声的研究进展

相控阵高强度聚焦超声(high Intensity focused ultrasound,HIFU)技术可以通过电子调相自由控制聚焦区域中焦点的形状、位置、个数等,实现高精度、高效率的治疗。文章主要介绍了相控聚焦超声的原理、阵型设计、声场优化、控制算法、电路设计以及换能器材料等几个方面。     

液体中高强度聚焦超声场及其测量

基于已知文献,文章介绍了液体中高强度聚焦超声场的基本性质,包括传播、频谱、吸收、聚焦、辐射力等特性,描述了它的物理图景和测量方法。     

高强度聚焦超声间歇式治疗中焦域温度分布的 仿真研究*

探究不同治疗深度、组织类型和治疗模式对高强度聚焦超声焦域温度场的影响。采用有限元法建立高强度聚焦超声辐照组织的二维轴对称仿真模型,通过Westervelt方程和Pennes生物热传导方程计算高强度聚焦超声焦域的声场和温度场分布。仿真结果表明:随着治疗深度的增加,焦域内温度逐渐降低,有效温升面积减小;不同组织类型在相同条件下的焦域温度不同,但焦域形状差别不大;单次治疗时间长、治疗时间间隔短的模式焦域温升速率快,有效温升面积区域大。焦域温度是高强度聚焦超声肿瘤治疗中判断治疗有效性和安全性的重要因素之一,该文通过数值仿真法,实现了预测高强度聚焦超声间歇式治疗模式下焦域组织温度场分布,有望为制定安全、有效的高强度聚焦超声术前治疗方案提供理论参考。     

基于FPGA的高强度聚焦超声相位控制系统设计*

多阵元相控阵换能器具有焦距可调和可实现经颅聚焦等优势,近来受到众多研究者的关注,其相位控制系统是决定多阵元相控换能器能否应用于临床的关键技术之一。在输出信号稳定的同时提高高强度聚焦超声相位控制系统精度是设计过程中的重点与难点。本文基于现场可编程门阵列设计了一种高强度聚焦超声相位控制系统。实测结果表明,多通道延时分辨率为1 ns,延时误差小于1 ns,可满足多阵元高强度聚焦超声治疗相控聚焦换能器延时精度的需要。     

高强度聚焦超声在医学超声领域中的发展与应用

高强度聚焦超声(high intensity focused ultrasound,简称HIFU)作为一种非侵入性、无毒副作用、具有巨大潜力的治疗肿瘤的手段,近年来已经越来越受到国内外学者的广泛关注。HIFU技术能将超声能量聚焦到人体组织的肿瘤内,产生高温,使肿瘤组织温度迅速上升至65℃以上,而发生不可逆转的凝固性坏死,从而达到消融肿瘤组织的目的。目前中国的HIFU肿瘤治疗技术和临床居国际领先。文章对HIFU在医学超声领域中的发展历史、现状和前景进行了探讨。     

热疗用聚焦超声换能器的研究

本文通过数值计算及实际测量,研究了凹球面声透镜聚焦换能器及凹球面自聚焦换能器产生的声场,证实此两种聚焦方式均可获得理想的聚焦效果,但自聚焦方式更适合高强度聚焦超声(HIFU)加热治疗。     

泌尿系统治疗用HIFU换能器的设计

高强度聚焦超声技术是‘种将超声能量聚焦于人体深部组织的狭小区域,形成足够高的声强,使组织瞬时在局部产生高温、无创性局部治疗肿瘤的新技术。近年来,泌尿系统疾病发病率迅速上升,尤其是前列腺疾病发病率高,相关的并发症也较多,已成为威胁男性生命健康的重要疾病。本文应用高强度聚焦超声技术,设计了治疗泌尿系统疾病的线阵换能器。仿真结果证明:该换能器的卢场能量集中,声强峰值尖锐,焦点尺十小,聚焦效果好,可以达到有效无损治疗的目的。     

高强度聚焦超声治疗子宫肌瘤中水囊耦合的影响评估*

水囊作为一种特殊的辅助器件在高强度聚焦超声治疗子宫肌瘤的过程中发挥着重要作用,但它同时也会让声通道变得更加复杂,对超声治疗效率和超声引导影像均造成负面影响。基于实际临床场景,利用k-Wave声学仿真软件建立高强度聚焦超声辐照靶组织及其超声引导过程的仿真模型,在有无水囊两个场景下,对治疗效率和监控影像质量进行定量评估。结果表明,加入水囊后,声波的聚焦性变差,焦域处的最高温度降低;通过分析超声图像的分辨率、对比度、对比噪声以及背景信噪比,发现加入水囊后超声图像的质量降低。建立的数值仿真模型能够初步评估水囊对治疗效率和监控影像质量的影响,可作为一种评估体系用于优化水囊参数,如水囊材料、厚度、形状、内部溶液成分等,为下一步实验探索对治疗效率和影像质量影响最小的水囊耦合方式提供评估手段。     

超声治癌与无损测温研究

至今已有很多关于超声治癌的研究。热疗已上升为治疗癌肿的主要方法之一。文中简述了热疗的历史发展，生物物理学基础和超声热疗的技术面貌，报道了对肿瘤或前列腺烧疗的高强度相控聚焦超声技术，它可在１０ｓ以内使肿瘤内升温超过７０℃。     

Applications of high-intensity focused ultrasound in medicine: Spotlight on neurological applications

High-intensity focused ultrasound (HIFU) has the potential to become a modality of treatment for a wide range of clinical conditions. HIFU enables non-invasive, selective ablation of tissues including tumors and punctured vessels. Another promising area of research within the field of therapeutic ultrasound is the application of HIFU to treat neurological disorders by selectively targeting the brain, spinal cord, or nerves. This paper provides an overview of the current applications of focused ultrasound in medicine with an emphasis on its use in the fields of neurology and neurosurgery.     

高强聚焦超声(HIFU)无创外科─21世纪治疗肿瘤的新技术

本文从简要回顾超声治疗的发展历史开始,重要介绍了90年代初在国际上兴起的HIFU无创外科技术及我国在该领域中的成就。文章继而对HIFU“切除”肿瘤的机理,治疗质量及其发展前景做了讨论。     

高强聚焦超声(HIFU)无创外科─21世纪治疗肿瘤的新技术

本文从简要回顾超声治疗的发展历史开始,重点介绍了９０年代初在国际上兴起的ＨＩＦＵ无创外科技术及我国在该领域中的成就．文章继而对ＨＩＦＵ“切除”肿瘤的机理,治疗质量及其及发展前景做了讨论．     

Ultrasound line-by-line scanning method of spatial–temporal active cavitation mapping for high-intensity focused ultrasound

This paper presented an ultrasound line-by-line scanning method of spatial–temporal active cavitation mapping applicable in a liquid or liquid filled tissue cavities exposed by high-intensity focused ultrasound (HIFU). Scattered signals from cavitation bubbles were obtained in a scan line immediately after one HIFU exposure, and then there was a waiting time of 2 s long enough to make the liquid back to the original state. As this pattern extended, an image was built up by sequentially measuring a series of such lines. The acquisition of the beamformed radiofrequency (RF) signals for a scan line was synchronized with HIFU exposure. The duration of HIFU exposure, as well as the delay of the interrogating pulse relative to the moment while HIFU was turned off, could vary from microseconds to seconds. The feasibility of this method was demonstrated in tap-water and a tap-water filled cavity in the tissue-mimicking gelatin–agar phantom as capable of observing temporal evolutions of cavitation bubble cloud with temporal resolution of several microseconds, lateral and axial resolution of 0.50 mm and 0.29 mm respectively. The dissolution process of cavitation bubble cloud and spatial distribution affected by cavitation previously generated were also investigated. Although the application is limited by the requirement for a gassy fluid (e.g. tap water, etc.) that allows replenishment of nuclei between HIFU exposures, the technique may be a useful tool in spatial–temporal cavitation mapping for HIFU with high precision and resolution, providing a reference for clinical therapy.     

Calibration and measurement issues for therapeutic ultrasound

This review paper examines some of the issues relating to calibration and measurement of therapeutic medical ultrasonic equipment (MUE). This is not intended to be an all-encompassing review of all aspects of characterising therapeutic ultrasound. Instead it concentrates on issues related to the acoustic output of two applications: physiotherapy and high intensity focused ultrasound surgery (HIFUS or HIFU; also referred to as high intensity therapeutic ultrasound, HITU). Physiotherapy has a well-established standards infrastructure for calibration: the requirements are small in number and well-defined. The issue for physiotherapy is not so much 'How to calibrate?' but rather, 'How to ensure that equipment IS calibrated?' The situation in the much newer area of HIFU is very different: the first steps towards writing standards are just starting and even the very basic questions of what to measure and with what type of sensor are open for debate. Readers whose main interest is in other ultrasound therapies will find ideas of relevance to their own specialty.     

高强度聚焦超声用于肿瘤治疗的研究

高强度聚焦超声（ＨＩＦＵ）能在短时间内使病变组织的温度升至７０℃以上,导致病变组织凝固坏死,是一种具有巨大潜力的、非侵入的、有效的肿瘤治疗手段。本文对ＨＩＦＵ的动物试验、临床应用及治疗装置的研究情况进行了总结,分析了该技术尚存在的问题,最后展望了其应用前景。     

HIFU治疗中换能器驱动电功率变化机制及规律*

高强度聚焦超声(HIFU)治疗中的驱动电功率对治疗效率起着非常关键的作用,驱动电功率控制的精准性势必会影响治疗的效率和安全性。前期研究表明：HIFU治疗过程中焦域瞬态物理特性的变化会导致换能器的负载阻抗发生变化,进而影响HIFU驱动电功率,但驱动电功率与焦域瞬态物理特性之间的影响关系及规律尚不明确。该文基于电压、电流传感器、空化检测探头和温度传感器等器件,构建了一种HIFU治疗中驱动电功率实时监测及焦域声空化、温度检测系统。基于该实验研究系统,以离体牛心组织作为HIFU辐照对象,分别研究了HIFU焦域温度变化、声空化及组织损伤与驱动电功率之间的变化关系及规律。研究结果表明：当焦域温度升高时,驱动电功率缓慢上升,驱动电功率与温度变化有良好的相关性;当空化产生时,驱动电功率出现明显的波动;当组织出现损伤时,驱动电功率呈陡然下降的变化。三种情景下,驱动电功率变化有明显区别,这有望为区分HIFU治疗过程中焦域处发生损伤和空化以及实时监测靶组织损伤程度提供一种新的解决方案。     

Microbubble-enhanced hemorrhage control using high intensity focused ultrasound

Our objective was to investigate whether hemorrhage control can be achieved faster when high-intensity focused ultrasound (HIFU) is applied in the presence of ultrasound contrast agents (UCA) as compared to HIFU only application. Incisions (3 cm long and 0.5 cm deep) were produced in the livers of anesthetized rabbits. UCA Optison (0.18 ml/kg) was injected into the mesenteric vein. A HIFU applicator (5.5 MHz, 6800 W/cm² in situ) was scanned at a rate of 1–2 mm/s in one direction over the incision (with multiple passes if needed), until hemostasis was achieved. Hemostasis times were 59 ± 23 s (n = 21) in the presence of Optison and 70 ± 23 s (n = 29) without Optison. The presence of Optison produced on average 37% reduction in hemostasis times normalized to initial bleeding rates (p < 0.05), as well as 60% faster formation of the coagulum seal over the incision (p < 0.05). Gross and histological observations showed similar appearance of HIFU lesions produced in the presence of Optison and HIFU lesions produced without Optison. Our results suggest potential utility of UCA for increasing efficiency of HIFU-induced hemostasis of solid organ injuries.     

Feasibility study of high intensity focused ultrasound (HIFU) for the treatment of hydatid cysts of the liver

This study evaluates the feasibility of using high intensity focused ultrasound (HIFU) for the treatment of hydatid cysts of the liver. HIFU ablation was carried out in 62 patients with echinococcosis of the liver. The mean age of patients was 40.76 ± 14.84 (range: 17–72 years). The effectiveness of the treatment was monitored in real-time by changes in the gray-scale, and by morphological studies, computed tomography, magnetic resonance imaging, and ultrasound.Criteria for evaluating the effectiveness of treatment in real time were outlines. Cytomorphological picture of destructive changes of parasitic elements was presented as well. Loss of embryonic elements of the parasite was observed at the subcellular level after HIFU-ablation and underlines the effectiveness of HIFU.