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目的 探讨高强度聚焦超声 (HIFU)体外破坏恶性实体肿瘤血管的临床影像学变化和病理学变化。方法 HIFU治疗恶性实体肿瘤患者 164例 ,通过数字减影血管造影、彩超、放射性核素显影分析肿瘤血管治疗前后的功能状态 ;3 0例患者治疗后常规外科手术 ,观察肿瘤血管的病理学变化。结果 临床影像学检查显示与治疗前比较 ,治疗后肿瘤异常血管网被破坏 ,肿瘤内血供减少或消失 ;光镜下肿瘤毛细血管、小血管管壁结构出现不可逆性损伤表现 ,腔内有血栓形成。结论 HIFU能从体外破坏肿瘤血管 ,加强了HIFU杀死肿瘤细胞的直接效应 ,这种选择性破坏血管作用有重要的临床意义。
Objective To investigate the clinical imaging changes and pathological changes of malignant solid tumor vessels damaged by high intensity focused ultrasound (HIFU) in vitro. Methods Totally 164 patients with malignant solid tumors were treated with HIFU. The functional status of the tumor before and after the treatment of tumor vessels was analyzed by digital subtraction angiography, color Doppler and radionuclide imaging. Thirty patients were followed up for routine surgery to observe the pathological changes of tumor vessels. Results Compared with those before treatment, the abnormal vascular network of the tumor was destroyed and the blood supply in the tumor decreased or disappeared. The tumor capillary and small vessel wall structure showed irreversible damage under light microscope, thrombus in the cavity form. Conclusion HIFU can destroy tumor blood vessels in vitro and enhance the direct effect of HIFU killing tumor cells. This selective destruction of blood vessels has important clinical significance.