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第 44 卷 第 1 期 Vol. 44, No. 1
2025 年 1 月 Journal of Applied Acoustics January, 2025
⋄ 研究论文 ⋄
高强度聚焦超声在腹部多层组织中的次生焦点问题 ∗
陈 丹 1 徐佳虹 1 赵封隆 1 史新旺 1 周小伟 1,2†
(1 重庆医科大学生物医学工程学院 超声医学工程国家重点实验室 重庆 400016)
(2 国家药品监督管理局超声手术设备质量评价重点实验室 武汉 430075)
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 C 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。
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
中图法分类号: O426.2 文献标识码: A 文章编号: 1000-310X(2025)01-0055-08
DOI: 10.11684/j.issn.1000-310X.2025.01.004
The secondary focus of high intensity focused ultrasound in multi-layer tissue
of abdomen
1
1
1
CHEN Dan , XU Jiahong , ZHAO Fenglong , SHI Xinwang and ZHOU Xiaowei 1,2
1
(1 State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering,
Chongqing Medical University, Chongqing 400016, China)
(2 NMPA Key Laboratory for Quality Evaluation of Ultrasonic Surgical Equipment, Wuhan 430075, China)
Abstract: 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 C. 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.
Keywords: High intensity focused ultrasound; Secondary focus; Skin injury; Uterine fibroids; Acoustic wave
reflection
2023-09-13 收稿; 2023-11-20 定稿
重庆市自然科学基金项目 (CSTB2022NSCQMSX0968), 2021 年重庆市留学人员回国创业创新支持项目 (cx2021022)
∗
作者简介: 陈丹 (1997– ), 女, 四川人, 硕士研究生, 研究方向: 超声声场传播。
† 通信作者 E-mail: zhou.xiaowei@cqmu.edu.cn