高强度聚焦超声用于晚期胰腺癌病人的止痛作用研究

目的探讨高强度聚焦超声（HIFU）对晚期胰腺癌止痛的疗效、并发症及安全性。方法应用FEP-BYO1高能聚焦超声肿瘤热疗机对42例晚期胰腺癌患者进行热疗，治疗时采用HIFU治疗病灶及腹腔神经丛的方法，观察治疗前后患者疼痛改变情况。结果42例患者治疗后疼痛消失5例（11．9％），疼痛减轻21例（50．0％），疼痛无改变7例（16．6％），治疗前后均无疼痛9例（21％）。JAMES评分：治疗前后评分差异存在显著意义（P〈0．05）。结论HIFU治疗能有效的缓解晚期胰腺癌患者的疼痛。     

Newly Developed Equipment and Methods in the Treatment of BPH: Analysis of Present Status

Benign prostatic hyperplasia (BPH) is the most common disease among the aged male population. A variety of symptoms are mainly caused by obstructive changes at the prostatic urethra. Transurethral resection (TURP) has been the gold standard of treatment, but new equipment and methods such as TUMT, HIFU, TUNA, and laser prostatectomy have been developed and are being tested for clinical application. Our experience with new equipment and methods show that their effectiveness has yet to be conclusively evaluated by objective parameters, while subjective improvements have been seen with less invasive treatments such as TUMT, HIFU and TUNA. Laser prostatectomy confirmed its advantages in hemostasis but comparison of each treatment is difficult because of different pathological changes created by different energy sources shown by MRI. Further studies are required to examine the new equipment and methods and for identification of the treatment of choice for BPH.     

高强度聚焦超声及其医学应用

HIFU技术的研究在国内外已掀起了热潮．到目前为止．HIFU技术已得到广泛的实验和临床支持。本文将对HIFU治疗设备的总体结构做一阐述．并讨论其在医学领域中的应用及发展方向。     

高强度聚焦超声在医学领域中应用的新进展

本文综述了国内外在高强度聚焦超声（high intensity focused ultrasound，HIFU）技术方面研究与应用的新进展。介绍了HIFU的治疗功能原理，特别给出了焦斑半径的具体计算公式和对相关组织的热效应、空化效应、机械效应，辐照效应等损伤机理，重点研究了热效应随声波频率及声强变化的规律。给出了HIFU的一般试验模型即分层组织模型以及HIFU应用与临床的情况。重点研究了HIFU源，主要讨论了换能器的聚焦方式（1）球面自聚焦换能器，（2）声透镜聚焦换能器，（3）大功率多元超声换能器，（4）电子扫描或相控阵列聚焦换能器，以及频率选择与目标深度和辐照强度的关系，并指出与其匹配的几类聚焦换能器的优缺点，列举了HIFU技术在泌尿科、肿瘤学、神经外科、眼科、妇科、止血以及其他医学领域中的最新应用。最后评价了目前HIFU在治疗方面的优势与某些不足以及可能改进的有效措施．展望了HIFU技术广阔的应用前景．     

High-intensity focused ultrasound in the treatment of breast fibroadenomata (HIFU-F trial)

Background: High-intensity focussed ultrasound (HIFU) is a non-invasive ablative technique utilising the application of high frequency ultrasound (US) pressure waves to cause tissue necrosis. This emerging technology is currently limited by prolonged treatment times. The aim of the HIFU-F trial was to perform circumferential HIFU treatment as a means of shortening treatment times.

Methods: A prospective trial was set up to treat 50 consecutive patients ≥18?years of age. Eligible patients possessed symptomatic fibroadenomata, visible on US. Patients ≥25?years of age required histological confirmation of the diagnosis. Primary outcome measures were reduction in treatment time, reduction in volume on US after 12?months and complication rates.

Results: HIFU treatment was performed in 51 patients (53 treatments) with a mean age of 29.8?years (SD 7.2?years) and a diameter of 2.6?cm (SD 1.4?cm). Circumferential ablation reduced treatment times by an estimated 19.9?min (SD 25.1?min), which is a 29.4% (SD 15.2%) reduction compared with whole lesion ablation. Volume reduction of 43.2% (SD 35.4%; p?t-test) was observed on US at 12?months post-treatment. Local complications completely resolved at 1 month apart from skin hyper-pigmentation, which persisted in nine cases at three months, six cases at 6 months and six at 12?months.

Conclusion: Circumferential HIFU treatment for breast fibroadenomata is feasible to reduce both lesion size and treatment time. HIFU is a non-invasive alternative technique for the treatment of breast fibroadenomata.

ISRCTN registration: 76622747     

利用磁共振成像实现肿瘤热疗中实时无创测温的方法

肿瘤热疗特别是高强度聚焦超声（HIFU）技术，已成为一种重要且非常具有前景的肿瘤治疗方法，温度是直接决定热疗效果的重要参数，实时准确的进行深部无创测温是目前制约肿瘤热疗进一步发展的一项关键技术。近来利用磁共振成像（MRI）进行无创测温，正受到越来越多的研究者的重视。本文简述了MRI无创测温的三种方法，比较了不同测温原理的特点和适用条件，报道了已有研究发展状况，并介绍了尚待解决的问题。