聚焦超声对黄羊鼻黏膜形态学的影响

Effect of focused ultrasound on morphology of nasal mucosa of sheep

目的研究聚焦超声对黄羊鼻黏膜形态学的影响。方法运用中国重庆海扶技术公司生产的CZB型超声波鼻炎治疗仪,在不同剂量参数下对离体牛肝进行直线扫描,观察聚焦超声在离体牛肝中形成的生物学焦域形态是否满足设计需要;以选择参数在鼻内镜下扫描活体黄羊下鼻甲鼻黏膜,通过大体形态、光镜和透射电镜观察聚焦超声扫描后黄羊鼻黏膜组织形态学的改变。结果离体牛肝实验结果显示在选择剂量参数下可获得满足设计需求的生物学焦域形态。聚焦超声扫描黄羊下鼻甲后,其黏膜外观和色泽无明显改变,但扫描后第3天鼻腔分泌物增加、第7天恢复正常。扫描后第3天,光镜下显示黄羊鼻黏膜上皮层完好,鼻黏膜下层出现散在、点状的凝固性坏死。凝固性坏死区血管内皮细胞变性、部分血管内血栓形成,神经细胞空化变性或坏死,腺体细胞部分或完全坏死。电镜显示鼻黏膜上皮杯状细胞、纤毛柱状上皮细胞等结构正常。在第7天凝固性坏死区出现胶原纤维增生等组织修复表现。在第14天坏死组织开始溶解吸收,部分切片显示坏死组织消融。结论在选择参数下聚焦超声能量可特异性沉积于鼻黏膜下层,对富含血管、神经和腺体的鼻黏膜组织消融,但不破坏鼻黏膜上皮层等非靶点区结构,从而可能维护鼻黏膜黏液纤毛系统功能。

OBJECTIVE To study the influence of focused ultrasound on the morphology of nasal mucosa in sheep. METHODS A model CZB ultrasound therapeutic system for rhinitis, developed and produced by Chongqing Haifu（HIFU）Technology Co.,Ltd.,Chongqing China,was used in this study. Linear scans were performed on bovine liver in vitro under different scan parameters, and the biologic focal field（BFF）was detected to evaluate if it met the requirements of designed. The nasal mucosa of inferior turbinate of sheep was exposed with the same scan parameters under the observation of nasal endoscope, and morphological changes of the nasal mucosa were observed by gross examination, light and electron microscopes. RESULTS This study revealed that the designed biological focal field in bovine liver in vitro could be obtained under the scan parameters mentioned above. Linear scan with the same condition,there was no obvious change in appearance and color of the treated nasal mucosa in the inferior turbinate of the sheep. However,3 days after treatment,there was an increased secretion in the nasal cavity, which recovered 7 days posttreatment. Light microscopic examination 3 days after exposure showed that the epithelia of the nasal mucosa was intact and there was diffused distribution of spot coagulated necroses in the subepithelia layer of treated nasal mucosa. Degeneration of vascular endothelial cells and thrombosis of blood vessels were found in the coagulated necrosis region. Besides,degeneration or necrosis of nerve cells was induced,and glandular cells were partially or completely damaged. The structure of epithelial goblet cells and ciliated cells in the treated observation of electronic microscope. At the seventh day after treatment,signs of tissue regeneration such as hyperplasia of collagen fiber were found in the coagulated region,and the necrosis tissue began to dissolve and was absorbed at the 14th day postparameters,the energy of focused ultrasound ceuld be deposited specifically at the subepithelia layer, and to ablate the targeted nasal mucous tissues which are rich in blood vessels,nerves and glands. There were no damage to the non-target area such as epithelial layer, which could maintain the normal structure and biological function of mucociliary of nasal mucosa.