Liver haemostasis using microbubble-enhanced ultrasound at a low acoustic intensity.

Abstract

OBJECTIVES:

To explore the haemostatic effects of microbubble-enhanced ultrasound (MEUS) at a very low acoustic intensity on the bleeding liver of rabbits.

METHODS:

Liver incisions made on 20 rabbits were treated with a pulsed therapeutic ultrasound transducer. The transducer was operated at 831 KHz with an acoustic intensity of 0.4 W/cm(2). The treatment was coordinated with intravenous injection of microbubbles. Ultrasound only and sham treatment served as the controls. Visual bleeding score and 10-min bleeding volume were evaluated for haemostatic efficacy. Contrast-enhanced ultrasound (CEUS) was performed to assess the liver perfusion. Nine treated livers were harvested for acute histological examination.

RESULTS:

Regarding the bleeding incisions made on rabbit livers, the haemorrhage stopped immediately after 2 min of MEUS treatment but bleeding continued in the controls treated by ultrasound or microbubble injection alone. The bleeding scores and the 10-min haemorrhagic volumes dropped significantly in the MEUS group compared with those of the controls (p < 0.01). The mechanism of MEUS haemostasis appears to involve the extensive swelling of hepatocytes and the haemorrhage of the portal area, which formed a joint compression on the regional liver circulation.

CONCLUSIONS:

Low acoustic intensity MEUS might provide a novel method for liver haemostasis.

KEY POINTS:

• This animal experiment demonstrates a novel method of controlling hepatic haemorrhage • The treatment uses therapeutic ultrasound during enhancement with intravenous microbubbles • This combined therapy was more effective than ultrasound or intravenous microbubbles alone • More work is required with larger animals before potential human trials.

• Authors: Xiaochen Zhao, Lu Li, Hongzhi Zhao, Tao Li, Shengzheng Wu, Yu Zhong, Yang Zhao, Zheng Liu
• Journal: European radiology (Eur Radiol) Vol. 22 Issue 2 Pg. 379-86 (Feb 2012) ISSN: 1432-1084 [Electronic] Germany
• PMID: 21965036 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Contrast Media

Topics

• Acoustics
• Animals
• Contrast Media (pharmacology)
• Hemorrhage (pathology, therapy)
• Hemostasis
• Hepatocytes (pathology)
• Liver (diagnostic imaging, pathology)
• Liver Diseases (diagnostic imaging, therapy)
• Microbubbles
• Necrosis
• Rabbits
• Transducers
• Ultrasonic Therapy (methods)
• Ultrasonics (methods)
• Ultrasonography