【作者】 王作军；

【导师】 曹铁生； 古幡；

【作者基本信息】 第四军医大学 ， 影像医学与核医学， 2008， 博士

【摘要】 为了提高超声溶栓治疗的安全性、有效性,我们设计了一种治疗与诊断双模式超声溶栓(DMUT)系统。其空间峰值时间平均功率(ISPTA)只有FDA规定的1/3,机械指数(MI)只有最大允许值的1/6,且治疗声束在空间及时间上都受到限制,以避免颅内驻波的形成及其可能危害。离体流路模型实验证实该系统可以明显增强tPA的溶栓作用,且可以提供多普勒诊断信息,以方便低频治疗超声的定位、并监测血管再开通过程的变化。此外,为了更加精确、高效地研究超声的溶栓增强作用,我们还设计了一种新的光学超声溶栓定量评价法。该方法利用照相技术,通过检查相片局部光亮度的变化,确定血栓厚度的变化,操作较简单,对血栓的人为影响小,具有良好的可重复性,同时可以区分不同声场位置处血栓厚度的变化。利用该方法,我们成功地证实:在离体条件下,普通经颅多普勒(TCD)超声诊断系统也有显著的溶栓促进作用。这既为临床应用TCD促进血栓溶解找到了部分依据,也显示了该实验方法具有很高的灵敏度。更多还原

【Abstract】 To improve the safety and efficiency of ultrasonic thrombolysis, we designed a dual mode ultrasonic thrombolysis (DMUT) system. Its spatial peak temporal average intensity was only 1/3 of that of the up-limit cleared by FDA, and its mechanic index was only 1/6 that of the cleared limit. It was also spatially and temporally restricted to avoid the forming of standing waves. Its effect in enhancement of TPA thrombolysis was confirmed by experiments with an in vitro flow model, and its ability to provide Doppler information of the blood flow, which can be used to aiming the therapeutic ultrasound beam and monitoring the recanalization process, was also demonstrated.Further, we also designed a new optical quantitative evaluation method for ultrasonic thrombolysis. It made use of photography to determine the thickness of clot by examining the photo brightness. With relatively simple operation and less personal interference, it had a rather good reproducibility, and could differentiate the thickness changes of different parts of the sound field. By this method we successfully demonstrated that a common TCD diagnostic system have the ability to enhance the thrombolysis significantly, thus provided the support for the clinical use of TCD for such objectives and showed the high sensitivity of this method.更多还原