| 陈丹,徐佳虹,赵封隆,史新旺,周小伟.高强度聚焦超声在腹部多层组织中的次生焦点问题*[J].,2025,44(1):55-62 |
| 高强度聚焦超声在腹部多层组织中的次生焦点问题* |
| The secondary focus of high intensity focused ultrasound in multi-layer tissue of abdomen |
| 投稿时间：2023-09-13 修订日期：2024-12-25 |
| 中文摘要: |
| 高强度聚焦超声治疗腹部子宫肌瘤时会出现皮肤及浅表组织烧伤。该文依据声传播理论模型，探究该问题背后的潜在原因。首先，建立治疗场景下皮肤、肌肉、脂肪等多层组织的声反射模型，得出组织界面处的声反射可形成次生焦点；之后，通过k-Wave仿真计算该次生焦点的声场和温度场，并探究其空间位置规律；最后，设计离体实验观察次生焦点。仿真结果表明，由于肌肉与脂肪间的声阻抗差较大，聚焦超声的入射声波在该界面处反射的能量确实可在组织内部二次聚焦，聚焦处的温度可达50℃甚至更高。并且，实验结果也与仿真计算吻合。该研究证实了高强度聚焦超声在腹部多层组织中可形成次生焦点，在一定条件下该次生焦点是导致皮肤及浅表组织烧伤的一个潜在因素。 |
| 英文摘要: |
| Burning of skin and its shallow tissue in the abdominal area is one of the most common complications during high intensity focused ultrasound (HIFU) treatment for uterine fibroids. This study aims at investigating the underlying mechanism of this issue from the perspective of acoustic propagation. Firstly, a simple theoretical model for acoustic reflection from multi-layer tissue boundaries (skin, fat, and muscle) was created to prove that the reflected waves could refocus at secondary locations. Secondly, a variety of simulations in k-Wave toolkit based on realistic scenarios were conducted to calculate the pressure field and temperature distribution of those secondary focuses, as well as their locations. Lastly, an ex-vivo experiment was designed to further validate existence of the secondary focus. It was found in the k-Wave simulations that mismatch in acoustic impedance between fat and muscle was the main reason for the secondary focus to occur, and temperature within the secondary focus reached over 50 oC. The existence of the secondary focus was also observed in the ex-vivo experiment. It can be concluded that secondary focuses are likely to take place during the HIFU treatment for uterine fibroids, which is a potential risk for burning the skin and other tissue during the surgery. |
| DOI：10.11684/j.issn.1000-310X.2025.01.004 |
| 中文关键词: 高强度聚焦超声 次生焦点 皮肤损伤 子宫肌瘤 声波反射 |
| 英文关键词: High Intensity Focused Ultrasound Secondary focus Skin injury Uterine fibroids Acoustic Wave Reflection. |
| 基金项目:基于超分辨率成像的聚焦超声治疗疗效评估；基于超声超分辨率成像的宫颈癌及癌前病变诊断； |
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