高强度聚焦超声辐照后细粒棘球蚴囊壁的病理变化

Pathological Change in Hydatid Cysts of Echinococcus granulosus Treated with High Intensity Focused Ultrasound

目的观察细粒棘球蚴囊壁在高强度聚焦超声(HIFU)辐照后的病理改变。方法采集感染细粒棘球蚴的新鲜羊肝,选取囊壁较薄、触摸弹性较好的细粒棘球蚴30个。采用随机抽样方法等分为3组,每组10个包囊。对照组,用普通诊断超声照射2min。处理组1和处理组2分别用150W和250W声功率对细粒棘球蚴包囊进行沿囊壁多层面的环形扫描,层面间距为5mm,扫描速度为3mm/s,照射时间2～10min(根据包囊大小)。取出照射后先肉眼观察细粒棘球蚴包囊大体改变,后取囊壁组织分别制作病理切片和透射电镜切片,观察其病理改变。结果HIFU(250W)辐照后,细粒棘球蚴包囊剪开处内囊壁立即发生卷曲,剥离出的内囊颜色变白、变硬、透光度降低。病理切片显示,HIFU辐照后细粒棘球蚴的内囊壁上角皮层与生发层大部分发生分离。电镜观察结果显示,HIFU辐照后细粒棘球蚴的角皮层纤维纹理明显改变,生发层细胞发生裂解性破坏。结论HIFU沿细粒棘球蚴囊壁的多层面的环形照射可明显损害细粒棘球蚴囊壁。

Objective To investigate the pathological change in Echinococcus granulosus hydatid cysts treated with high intensity focus ultrasound （HIFU）. Methods Thirty cysts with thinner wall and proper elasticity, taken from livers of infected sheep, were randomly divided into three groups. By cyclical muhilayer radiation around the cyst wall, two experiment groups were treated with HIFU under 150 W and 250 W sound power respectively. The control group was treated by ordinary ultrasound for 2 min. Results The inner cyst wall of hydatid treated with HIFU became curved, thicker, stiffer, white and less transparent. The germinal layer was detached mostly from the laminated layers of hydatid in the experiment groups. Images from the transmission electron microscopy showed that in the experiment groups fabric texture of hydatid changed significantly and germinal cells were broken. Conclusion HIFU in a model of cyclical multilayer radiation causes pathological damage of the E. granulosus hydatid.