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目的研究微泡增强的超声空化技术可能对兔肌肉和肺微血管产生的损伤作用。方法将15只新西兰大白兔联合静脉注射微泡的同时予以CZ-960超声空化治疗仪辐照任意一侧腿部肌肉及右肺各5 min,其中5只兔于治疗后即刻获取肌肉和肺进行病理检查,其余10只兔于治疗前,治疗后即刻、30、60 min和48 h行兔腿部肌肉超声造影,视觉观察并测量各时间点造影峰值强度(contrast peak intensity,PI)变化。48 h造影后,再获取其中5只动物的肌肉和肺进行病理检查。结果超声空化作用后,靶区兔肌肉和肺表面均产生点状或小片状出血。空化作用前后各时间点肌肉造影PI值无明显差异(P>0.05)。光镜下可见经空化作用后即刻,肌束间有微小的局灶性出血、水肿,无坏死情况,肺间质可见弥漫的微小血管出血;空化作用48 h后,肌束间出现微小灶性坏死,坏死灶面积占视野总面积的1%~2%。肺间质出现散在的微小出血灶。结论微泡增强的超声空化效应在即刻空化治疗中可致肌肉和肺微小出血灶形成,肺损伤范围局限,对肌肉的整体血流灌注无明显影响。故超声空化治疗对肌肉和肺正常微血管的损伤作用不大。
Objective To study the effect of ultrasound-enhanced cavitation on the muscle and pulmonary microvascular in rabbits. Methods Fifteen New Zealand white rabbits were injected with microvesicles simultaneously and irradiated with CZ-960 ultrasonic cavitation therapy instrument for 5 min on both leg muscles and right lung. Five rabbits received muscle and lung immediately after treatment Pathological examinations were performed. The other 10 rabbits were examined by contrast-enhanced ultrasonography before and 30, 60, and 48 h after treatment. Visual acuity and contrast peak intensity (PI) at each time point were measured. 48 h after angiography, and then obtained the five animals in the muscle and lung pathological examination. Results Ultrasonic cavitation, the target area of rabbit muscle and lung surface have punctate or small pieces of hemorrhage. There was no significant difference in the value of muscle contrast between before and after cavitation (P> 0.05). Light microscopic visualization immediately after cavitation, there was a slight flechage between the muscle bundles, edema, no necrosis, diffuse small blood vessels seen in the interstitial lung; cavitation after 48 h, the appearance of tiny Focal necrosis, necrosis area of the total area of 1% to 2%. Pulmonary interstitial scattered tiny hemorrhage occurred. Conclusion Microbubble enhanced ultrasound cavitation can cause the formation of tiny hemorrhagic foci in the muscle and lung in the cavitation treatment. The scope of the lung injury is limited, which has no obvious effect on the whole blood perfusion of the muscle. Therefore, ultrasonic cavitation treatment of muscle and lung damage of normal microvascular little effect.