组织碎化术非侵入性超声肝脏消融：离体猪肝可行性及啮齿动物慢性在体研究
本研究使用自制42阵元半球形聚焦换能器组织碎化术系统，在离体猪肝验证完全机械消融且无热损伤，并在啮齿动物在体评估急性与慢性效应，终点为消融后0、3、7、14、28天，显示靶区肝组织可修复再生，支持组织碎化术的有效性与安全性。
要点
- 组织碎化术可完全机械消融肝组织且无热损伤，靶区可修复再生。
- 使用42阵元、焦距13.5 cm、孔径24 cm、710 kHz、f-number 0.2083换能器。
- 参数介于内在阈值空化与冲击散射组织碎化术之间，脉宽1-3 μs、PRF 166-250 Hz、压力>50 MPa。
核心结论
- 自制组织碎化术系统可实现离体与在体肝组织完全机械消融且不诱导热损伤。
- 与高强度聚焦超声不同，组织碎化术后靶区肝组织能够修复和再生，保证安全性和可靠性。
- 本研究为组织碎化术的有效性和安全性提供了进一步证据。
研究设计与样本
- 研究为离体猪肝可行性实验加啮齿动物在体急性与慢性观察实验。
- 采用自制组织碎化术系统，换能器为42阵元近半球形聚焦阵列，焦距13.5 cm、孔径24 cm、频率710 kHz、f-number 0.2083。
- 在体啮齿动物模型观察终点为消融后0、3、7、14、28天。
- 消融表征采用苏木精-伊红染色，Masson三色染色观察胶原纤维沉积与分布，TUNEL法揭示凋亡时空演变。
- 检测α-SMA与TGF-β表达追踪在体纤维化激活与消退过程，并检测血清丙氨酸氨基转移酶和天冬氨酸氨基转移酶评估肝功能。
关键影像表现/征象
- 离体与在体肝组织均实现完全机械消融，未诱导热损伤。
- 靶区肝组织在组织碎化术后表现出修复和再生能力。
- 通过HE、Masson、TUNEL及α-SMA、TGF-β检测表征了消融后凋亡与纤维化激活消退的时空演变。
诊断标准与关键数值
- 组织碎化术参数为脉宽1-3 μs、脉冲重复频率166-250 Hz、压力>50 MPa，类型介于内在阈值空化与冲击散射组织碎化术之间。
临床应用与阅片要点
- 组织碎化术作为非侵入性肝脏消融方式，消融后靶区无热损伤且可修复再生，阅片时需注意与热消融后改变鉴别。
- 随访影像评估应关注靶区修复再生过程，结合血清转氨酶动态理解肝功能变化。
局限性
- 离体实验采用猪肝，在体实验采用啮齿动物模型，尚未在人体或大动物中验证。
- 研究为可行性及观察性实验，样本量未报告，设备为自制系统。
以上解读依据论文摘要（全文未开放获取或许可不允许翻译转载）。
英文原文（摘要）· 点击展开
OBJECTIVE: This study aimed to investigate the feasibility of histotripsy ablating the liver ex vivo, as well as characterize the acute and chronic impact of histotripsy in vivo.
METHODS: A home-made histotripsy system was used to treat liver tissues. A 42-element near-half spherical focusing transducer array was designed with a 13.5 cm focal length, 24 cm aperture and 710 kHz frequency, with an f-number of 0.2083. Initial parameter exploration was measured. The type of histotripsy used lies between the intrinsic threshold cavitation and shock-scattering histotripsy with a pulse duration of 1-3 μs, pulse repetition frequency range of 166-250 Hz and pressure of >50 MPa. Acute and chronic observational experiments were utilized in rodent models in vivo to assess the efficacy and safety of histotripsy, with endpoints at 0, 3, 7, 14 and 28 d post-ablation. Ablation was characterized using hematoxylin-eosin staining, with Masson's trichrome staining conducted to visualize the deposition and distribution of collagen fibers, and TdT-mediated dUTP nick-end labeling (TUNEL) assay used to reveal the spatiotemporal evolution of apoptosis. α-SMA and TGF-β expression was detected to track the process of fibrosis activation and regression in vivo. Serum alanine aminotransferase and aspartate aminotransferase were detected to examine liver function.
RESULTS: The XC-100 histotripsy system developed by the study was able to achieve complete mechanical ablation of both ex vivo and in vivo liver tissues without inducing thermal damage. Unlike high-intensity focused ultrasound, the liver tissue in the targeted area post-histotripsy demonstrated the ability to repair and regenerate, thereby ensuring safety and reliability.
CONCLUSION: This study provides further evidence for the effectiveness and safety of histotripsy.
引用
- Wei Y, Li S, Wang Q, et al. Non-invasive Ultrasound Liver Ablation Using Histotripsy: A Feasibility Study in Ex Vivo Porcine Liver and a Chronic Study in Rodent Models In Vivo. Ultrasound Med Biol. 2026. PMID: 42091361. doi:10.1016/j.ultrasmedbio.2026.03.001
供执业医师工作参考，不替代临床判断；数值与分级以指南原文为准。