高强度聚焦超声肿瘤治疗焦域的仿真研究

数值仿真是预测高强度聚焦超声(high intensity focused ultrasound,HIFU)治疗的温度分布、确定治疗剂量的有效方法之一。本研究采用Westervelt方程的近似式,并结合Pennes生物热传导方程,以猪肝肿瘤为例,在考虑肝组织声学特性对HIFU温度场影响的条件下,通过时域有限差分法仿真研究辐照时间和声强对肿瘤组织内可治疗焦域体积的影响。研究结果表明,一定声强条件下,肝组织声学特性对肿瘤内可治疗焦域的影响随着辐照时间的延长而凸显;可治疗焦域体积随时间增长或声强增大而非线性增加;相同辐照条件下,肿瘤组织内的可治疗焦域体积大于肝组织内的;当可治疗焦域体积一定时,辐照声强和辐照时间呈负相关;同时,等效热剂量判定的可治疗焦域大于温度阈值判定的可治疗焦域,且二者之差随声强而变化。     

高强度聚焦超声在治疗肝癌中的研究进展

肝癌是我国常见的恶性肿瘤之一,手术切除是治疗肝癌的首选治疗方法,但是大多数患者发现时多数为中晚期,无法进行手术切除.高强度聚集超声(HIFU)是一种非侵袭性的治疗方法,在肝癌的治疗中发挥着举足轻重的作用.为此作者对HIFU治疗肝癌的原理、提高免疫力的作用及抑制肝癌侵袭和转移的作用进行阐述,为临床治疗该病提供参考.     

高强度聚焦超声在治疗肝癌中的研究进展

肝癌是我国常见的恶性肿瘤之一,手术切除是治疗肝癌的首选治疗方法,但是大多数患者发现时多数为中晚期,无法进行手术切除。高强度聚集超声(HIFU)是一种非侵袭性的治疗方法,在肝癌的治疗中发挥着举足轻重的作用。为此作者对HIFU治疗肝癌的原理、提高免疫力的作用及抑制肝癌侵袭和转移的作用进行阐述,为临床治疗该病提供参考。     

高强度聚焦超声换能器温度场的数值仿真

相控阵高强度聚焦超声换能器可以通过换能器上不同阵元发射超声波的时间不同来实现变焦、多焦点。该论文应用Westervelt方程的近似式,结合Pennes热传导方程,以人体乳房为例,FDTD(finite difference time domain)仿真对比研究平面阵列相控聚焦换能器与曲面阵列相控聚焦换能器形成温度场的特性,同时数值仿真研究不同占空比的正弦激励函数、不同治疗频率、声强对曲面阵列相控聚焦换能器超声温度场的影响。研究结果表明曲面阵列相控聚焦换能器能有效地减少皮肤处的温升,对皮肤的伤害较小;对于曲面阵列相控聚焦换能器,不同占空比的正弦激励函数形成的可治疗区域(60℃以上)大小差别不大,但最高温度不同;随着频率升高,形成的可治疗区域体积减小;随着输入声强的增大,可治疗区域变大,但焦距不变。     

高强度聚焦超声治疗子宫肌瘤300例的临床疗效分析

目的：探讨高强度聚焦超声（high intensity focused ultrasound,HIFU）治疗子宫肌瘤的临床疗效及其安全性。方法：回顾性分析我院2007年1月～2011年1月300例采用高强度聚焦超声治疗的子宫肌瘤患者的临床资料,比较分析治疗前后瘤体大小、病灶内部回声、临床症状改善情况、血流的变化及超声造影图像改变。结果：HIFU治疗后1、3、6及12个月,瘤体体积均较治疗前显著缩小（P〈0.05）,显效率80.33%（241例）,有效率19.33%（58例）,无效率0.33%（1例）,肌瘤所致的临床症状减轻或消失,瘤体内部回声增强,彩色血流均消失,超声造影瘤体内无灌注。治疗期间,患者出现治疗部位疼痛、骶尾部酸胀及肛门坠胀,治疗结束时症状消失;治疗过程中出现腿部疼痛、麻木症状,经过重新定位后症状消失,少数出现阴道少量流血,给予止血药;治疗后出现血尿,经大量喝水排尿后消失。结论：HIFU治疗子宫肌瘤是安全有效的,在妇科领域便于推广。     

基于频谱图像灰度共生矩阵的无损测温方法

本文提出了一种基于哈达玛变换的频谱图像灰度共生矩阵(Hadamard-GLCM)的高强度聚焦超声治疗无损测温方法。利用高强度聚焦超声辐照新鲜离体猪肉组织,获取辐照前后的B超图像的减影图像,采用Hadamard变换对其进行处理,获取频谱图像,将频谱图像的灰度共生矩阵惯性矩作为反应温度变化的信息参数。实验表明:不仅单组数据的Hadamard-GLCM惯性矩(HGMI)和温度能很好的线性拟合,而且多组数据的Hadamard-GLCM惯性矩与温度也成近似的线性关系,而且斜率非常接近,拟合度更接近1,误差小,对温度的分辨能力高,容错能力强,与传统的测温方法相比有着明显的优势,能为HIFU治疗过程中的无损测温提供有效的实时依据。     

高强度聚焦超声可治疗区域的仿真研究

数值仿真不同治疗参数条件下高强度聚焦超声(high intensity focused ultrasound,HIFU)可治疗区域的变化,对HIFU治疗剂量的确定具有重要的指导意义。本文采用Westervelt方程的近似式,结合Pennes生物热传导方程,以离体猪肝组织为例,在考虑组织声学特性对HIFU焦域温度场影响的条件下,通过时域有限差分法(finite difference time domain,FDTD)对HIFU焦域温度场进行仿真研究。研究结果表明,照射时间越长,组织声学特性的影响就越明显;焦点处的最高温升相同时,可治疗区域的大小差异较小;声强越大,形成可治疗区域所需的时间也越短;当声强一定时,随着照射时间的增加,可治疗区域的长、短轴长度均呈非线性增加;在相同可治疗区域的长轴或短轴长度一定时,输入声强和照射时间呈负相关。     

高强度聚焦超声对人膀胱癌细胞的生长抑制作用及机理研究

研究高强度聚焦超声（high intensity focused ultrasound,HIFU）对人膀胱癌细胞的杀伤作用,并探索其作用机理.用不同强度的HIFU处理人膀胱癌细胞T24,用台盼蓝排斥法染色、细胞增殖试验（MTT法）研究HIFU对癌细胞的杀伤和生长抑制作用;流式细胞术检测其对癌细胞周期、凋亡及相关基因表达的影响.HIFU处理后,癌细胞死亡率升高,增殖活性降低,G0/G1期细胞数增加,S期细胞数减少,凋亡指数升高,与对照组比较,差异有显著性意义（P＜0.05）;P53、BCL-2和FAS表达阳性细胞数与对照组比较,无显著性意义（P＞0.05）;HIFU强度为600 W/cm^2时,HSP70表达阳性细胞数升高,与对照组比较差异有显著性意义（P＜0.05）.HIFU对人膀胱癌细胞T24具有明显的杀伤及抑制作用,其机理与抑制DNA合成有关;HIFU具有诱导癌细胞凋亡的作用,其诱导凋亡作用可能与P53、BCL-2和FAS无关.     

高能聚焦超声在治疗晚期胰腺癌中的疗效分析

目的：通过对晚期胰腺癌患者行高强度聚焦超声治疗,观察其近期疗效,为晚期胰腺癌患者的临床治疗提供一种新的选择。方法：对15例晚期胰腺癌患者行高强度聚焦超声治疗,对比治疗前后的KPS评分,疼痛感受评分,CA199,三大常规,生化检查,B超观察肿瘤回声及血供,CT观察肿瘤大小改变。结果：HIFU治疗后,患者KPS评分升高,疼痛评分下降,肿瘤标志物下降,B超观察肿瘤回声,其中10例肿瘤回声增强,11例肿瘤血供减少或消失,CT示大部分患者治疗后肿瘤体积缩小或不变,治疗后三大常规、生化和电解质无明显改变。结论：运用高强度聚焦超声治疗晚期胰腺癌患者,在改善患者临床症状方面有明显疗效,并且能缩小肿瘤体积,减少或中断肿瘤血供,是一种很有发展前景的无创治疗方法。     

高强度聚焦超声在药物控制释放的应用及进展

高强度聚焦超声能够以一种非侵入性的方式有效地穿透身体内部组织,聚焦在深层组织中一个很小的空间区域内,产生很强的声能,这些能量被组织吸收引起局部温度的升高。当温度到达热敏脂质体的相变温度时,磷脂烷基链构象的会发生改变,导致脂质体的通透性增强,从而能够促进药物的释放。因此,高强度聚焦超声可以被用作外源刺激控制体内特定位置热敏脂质体的药物释放。本文对高强度聚焦超声在药物控制释放领域的应用及进展进行综述。     

Modeling and Predicting Tissue Movement and Deformation for High Intensity Focused Ultrasound Therapy

PurposeIn ultrasound-guided High Intensity Focused Ultrasound (HIFU) therapy, the target tissue (such as a tumor) often moves and/or deforms in response to an external force. This problem creates difficulties in treating patients and can lead to the destruction of normal tissue. In order to solve this problem, we present a novel method to model and predict the movement and deformation of the target tissue during ultrasound-guided HIFU therapy.MethodsOur method computationally predicts the position of the target tissue under external force. This prediction allows appropriate adjustments in the focal region during the application of HIFU so that the treatment head is kept aligned with the diseased tissue through the course of therapy. To accomplish this goal, we utilize the cow tissue as the experimental target tissue to collect spatial sequences of ultrasound images using the HIFU equipment. A Geodesic Localized Chan-Vese (GLCV) model is developed to segment the target tissue images. A 3D target tissue model is built based on the segmented results. A versatile particle framework is constructed based on Smoothed Particle Hydrodynamics (SPH) to model the movement and deformation of the target tissue. Further, an iterative parameter estimation algorithm is utilized to determine the essential parameters of the versatile particle framework. Finally, the versatile particle framework with the determined parameters is used to estimate the movement and deformation of the target tissue.ResultsTo validate our method, we compare the predicted contours with the ground truth contours. We found that the lowest, highest and average Dice Similarity Coefficient (DSC) values between predicted and ground truth contours were, respectively, 0.9615, 0.9770 and 0.9697.ConclusionOur experimental result indicates that the proposed method can effectively predict the dynamic contours of the moving and deforming tissue during ultrasound-guided HIFU therapy.     

High-Intensity Focused Ultrasound in Functional Neurosurgery

Stereotactic functional neurosurgical interventions for basal ganglia are an important method for treating pain, obsessive–compulsive, movement and depressive disorders. These interventions include destructive surgeries and deep brain stimulation through implanted electrodes. Destructive surgeries have a number of serious limitations, since they are associated with a higher risk of complications, especially in case of bilateral interventions. High-intensity focused ultrasound (HIFU) is a novel noninvasive approach proposed for destruction of a certain target point in the brain. We discuss the technical foundations of HIFU, thoroughly analyze the advantages and drawbacks of the method compared to other methods of modern functional neurosurgery, and summarize the first results of using HIFU in the world’s leading clinics. Further accumulation of experience is needed to perform a well-considered analysis of the potential of HIFU and to assess the long-term effects of the interventions performed and the role of this procedure in the algorithms for treating various nervous system diseases.     

超声波骨密度测量技术的最新进展

骨质疏松等中老年的常见病和多发病也呈年轻化发展,如何进行有效的骨状况诊断,拥有一台可以信赖的、可以方便地应用的骨测量仪器显得更为重要。超声波骨测量技术是使用范围比较广泛的一种,本文对超声波测量法的最新发展进行了阐述。     

Determination of Tissue Thermal Conductivity by Measuring and Modeling Temperature Rise Induced in Tissue by Pulsed Focused Ultrasound

A tissue thermal conductivity (K_s) is an important parameter which knowledge is essential whenever thermal fields induced in selected organs are predicted. The main objective of this study was to develop an alternative ultrasonic method for determining K_s of tissues in vitro suitable for living tissues. First, the method involves measuring of temperature-time T(t) rises induced in a tested tissue sample by a pulsed focused ultrasound with measured acoustic properties using thermocouples located on the acoustic beam axis. Measurements were performed for 20-cycle tone bursts with a 2 MHz frequency, 0.2 duty-cycle and 3 different initial pressures corresponding to average acoustic powers equal to 0.7 W, 1.4 W and 2.1 W generated from a circular focused transducer with a diameter of 15 mm and f-number of 1.7 in a two-layer system of media: water/beef liver. Measurement results allowed to determine position of maximum heating located inside the beef liver. It was found that this position is at the same axial distance from the source as the maximum peak-peak pressure calculated for each nonlinear beam produced in the two-layer system of media. Then, the method involves modeling of T(t) at the point of maximum heating and fitting it to the experimental data by adjusting K_s. The averaged value of K_s determined by the proposed method was found to be 0.5±0.02 W/(m·°C) being in good agreement with values determined by other methods. The proposed method is suitable for determining K_s of some animal tissues in vivo (for example a rat liver).     

面向经颅聚焦超声的多阵元相控阵关键技术

经颅聚焦超声是一种有效的神经调控技术,具有非侵入性、聚焦靶点多和焦点可调控等优势。但由于颅骨的强声衰减和非均质特性,聚焦超声经颅后存在焦点偏移、焦域能量不足以及颅骨烫伤等问题。多阵元超声相控阵可以修正超声经颅后的相位偏差和幅值衰减,实现准确、有效的颅内聚焦。本文首先介绍了换能器的阵元排布方式,进一步归纳了相控阵激励信号的调控方法,最后对其基础研究和临床应用进行了回顾与展望。