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

  • Ultrasound
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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/cm2. 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.

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Acknowledgements

This work was supported by Chongqing Science and Technology Project (No. 2011GGB044) and Natural Science Foundation of China (No. 30672014). We would like to thank Dr. Chunji Huang and Dr. Rong Zhang for their help on management. We also thank Dr. Zaigen Zhang for pathological examinations.

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Authors and Affiliations

  1. Department of Ultrasound, Xinqiao Hospital, The Third Military Medical University, Chongqing, 400037, China

    Xiaochen Zhao, Lu Li, Hongzhi Zhao, Shengzheng Wu, Yu Zhong, Yang Zhao & Zheng Liu

  2. Department of Ultrasound, Daping Hospital, The Third Military Medical University, Chongqing, China

    Tao Li

Authors
  1. Xiaochen Zhao
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  2. Lu Li
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  3. Hongzhi Zhao
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  4. Tao Li
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  5. Shengzheng Wu
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  6. Yu Zhong
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  7. Yang Zhao
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  8. Zheng Liu
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Corresponding author

Correspondence to Zheng Liu.

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Zhao, X., Li, L., Zhao, H. et al. Liver haemostasis using microbubble-enhanced ultrasound at a low acoustic intensity. Eur Radiol 22, 379–386 (2012). https://doi.org/10.1007/s00330-011-2273-5

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  • DOI: https://doi.org/10.1007/s00330-011-2273-5

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