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OBJECTIVE@#To investigate the effect of low-intensity pulsed ultrasound (LIPUS) on hematopoietic function in rats after combined chemotherapy with doxorubicin and cyclophosphamide.@*METHODS@#Eighty rats were randomized into control group and LIPUS group (=40) for treatment with intraperitoneal injection of doxorubicin (2 mg/kg)+cyclophosphamide (20 mg/kg) for 4 consecutive days and continuous irradiation with LIPUS for 7 days following the injections, respectively. The white blood cells, red blood cells and platelets counts in each group were measured at 0, 4, 7, 9, 11, 14 and 18 days after the start of drug administration. The pathological sections of the bone marrow were examined at 0, 4 and 11 days, and the flow cytometry was performed for detecting the cell apoptosis; qPCR was performed for detecting the expressions of SCF, ICAM-1, and VCAM-1 mRNAs, and ELISA was used to detect the expressions of IL-3 and GM-CSF.@*RESULTS@#The white blood cell count was significantly higher in LIPUS group than in the control group ( < 0.05). Histopathological examination of the bone marrow revealed significantly increased hematopoietic tissue in LIPUS group ( < 0.05). Flow cytometry demonstrated an obviously lower cell apoptosis rate in the bone marrow in LIPUS group than in the control group ( < 0.05). Compared with those in the control group, the mRNA expression levels of ICAM-1 and VCAM-1 as well as the protein levels of IL-3 and GM-CSF were significantly increased in LIPUS group ( < 0.05).@*CONCLUSIONS@#LIPUS can alleviate the hematopoietic damage after combined chemotherapy with doxorubicin with cyclophosphamide probably by increasing the expressions of ICAM- 1, VCAM-1, IL- 3, and GM-CSF.
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Animales , Ratas , Médula Ósea , Ciclofosfamida , Doxorrubicina , Trasplante de Células Madre Hematopoyéticas , Ondas UltrasónicasRESUMEN
Objective To investigate the impact of low intensity pulsed ultrasound (LIPUS) with different intensities on the migration of bone marrow mesenchymal stem cells (BMSCs) in vitro.Methods BMSCs were divided into control group,30 mW/cm2 group,60 mW/cm2 group and 90 mW/cm2 group.Control group was treated by sham LIPUS exposure,and the other three groups were treated by LIPUS with corresponding intensities.The impact of LIPUS on scratch healing was tested with scratch assay,and the interference of proliferation was eliminated with MTT assay.The migration of BMSCs were evaluated with transwell migration assay.The expression of F-actin was analyzed with fluorescein isothiocyanate (FITC) fluorescent coloration.Results 24 h and 48 h after LIPUS exposure,there were statistical differences of scratch area among groups (F=26.559,106.110,both P＜0.001),and the scratch area of control group was the largest ([0.93 ± 0.26)mm2 of 24 h after LIPUS exposure and [0.70 ± 0.11]mm2 of 48 h after LIPUS exposure),while that of 30 mW/cm2 group was the smallest ([0.47 ±0.21]mm2 of 24 h after LIPUS exposure and [0.19±0.10]mm2 of 48 h after LIPUS exposure).There was no statistical difference of scratch area among the four groups immediately after LIPUS exposure (F=2.921,P=0.063).MTT assay results showed there was no statistical difference of absorbance among the four groups immediately,nor 24 h,48 h after LIPUS exposure (F=1.616,0.720,1.408;P=0.196,0.544,0.378).Significant difference was found in the number of cells migrated through the transwell chamber among the four groups (F=43.145,P＜0.001),and the cell number of 30 mW/cm2 group was the largest (212.53±35.32),while that of the control group was the least (89.53±19.27).F-actin fluorescence staining results showed the morphology of F-actin was changed after LIPUS exposure.The cytoskeleton became narrow and elongated.Statistical difference of relative fluorescence intensity was found among the four groups (F 64.350,P＜0.001).The relative fluorescence intensity of 30 mW/cm2 group was the largest (125.43 ± 17.43),while that of control group was the least (51.94± 12.76).Conclusion LIPUS can promote the migration ability of BMSCs in vitro with the best intensity was 30 mW/cm2.
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Objective To investigate the effect of signal characteristics of MR T2WI for predicting HIFU treatment outcome for adenomyosis.Methods According to signal characteristics of MR T2WI before HIFU treatment,502 adenomyosis patients were divided into group Ⅰ (lesions with most hypointense and/or little isointense) and group Ⅱ (lesions with most isointense and/or little hypointense).Then patients in each group were further subdivided into subgroup A (without slightly and extremely hyperintense foci in the lesions),subgroup B (with slightly hyperintense foci in the lesions) or subgroup C (with extremely and/or slightly hyperintense foci in the lesions).The correlation of signal characteristics of MR T2WI for adenomyosis on HIFU ablation results and parameters were analyzed.Results There was no statistical difference of non-perfused volume ratio (NPVR) between group Ⅰ and group Ⅱ (t=-0.504,P=0.612).In both group Ⅰ and group Ⅱ,NPVR of subgroup A was higher than that of subgroup B and subgroup C,respectively (group Ⅰ:LSD-t=2.608,3.677,P=0.009,＜0.001;group Ⅱ:LSD-t=3.255,3.778,P=0.001,＜0.001).There was no statistical difference of NPVR between subgroup B and subgroup C (group Ⅰ:LSD-t=-0.852,P=0.395;group Ⅱ:LSD-t=0.278,P=0.781).There was no statistical difference of sonication time,total ablation energy and energyefficiency factor (EEF) between group Ⅰ and group Ⅱ,respectively (sonication time:t=-1.716,P=0.087;total ablation energy:t=-1.676,P=0.094;EEF:Z=0.044,P=0.965).In both group Ⅰ and group Ⅱ,sonicationtime,total ablation energy and EEF of subgroup A were lower than those of subgroup B and subgroup C (all P＜0.05),while no statistical difference was found between subgroup B and subgroup C (all P＞0.05).Conclusion Signal characteristics of adenomyosis on MR T2WI can be used as predictors of HIFU treatment outcome for adenomyosis.
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Focused ultrasound surgery (FUS) technology has been used for clinical treatment more than 20 years. Since 2011, relying on the "high intensity focused ultrasound tumor therapy training base", focusing ultrasound surgeons on the treatment of uterine fibroids, based on the basic theories and skills provided by interns who have just access to the qualification of licensed physicians, the training courses are set such as engineering technology principles, biological effects and mechanisms, micro and non-invasive concepts and clinical thinking, image recognition ability, operation training, and postoperative complications management etc.. After strict quality training and performance evaluation, the initial training of focused ultrasound surgeons has been completed. Moreover, the training object can consolidate learning effect through continuing education in order to acquire stable skills and skills.
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Objectives To investigate the relationship between the degeneration of lumbar multifidus mus-cles and facet joint osteoarthritis(FJOA)by MRI. Methods This retrospective study included 248 patients with low back and leg pain,aged from 55 to 70.MRI was used to measure TCSA,FCSA,fCSA and FI% of the L4~5and L5~S1segments on the both sides of their multifidus muscle in the cross section in T2weighted image.All the cases were divided into three grades:grade 0~1,grade 2 and grade 3 according to their FJOA grades. The relationship between the FJOA grades at the same level and TCSA,FCSA and FI% of both sides was analyzed retrospectively. Results There were significant differences of the FI% of the multifidus muscle between both sides of the two seg-ments(P < 0.05);The TCSA,FCSA and fCSA of the left and right multifidus muscle all showed an increasing trend from L4~5to L5~S1segment and the difference was statistically significant(P<0.05);the FI% of two sides of multifidus muscle was negatively correlated with the right FJOA grade at L5~S1segment(P<0.05).There was a re-lationship between females and right FJOA grade at L5~S1segment(all P < 0.05). Whereas,no significant differ-ence was found in other parameters(all P>0.05).Conclusions There is no relationship between the cross-sec-tional area of the multifidus muscle and the FJOA grade. The higher FI% degree of multifidus muscle in the L5~S1 segment is accompanied with a lower grade of FJOA.The degeneration of multifidus muscle occurs earlier than the degeneration of articular process joints,so the earlier exercise of lumbar muscle is recommended.
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Objective To investigate the value of quantitative parameters of CEUS in predicting the effect of ultrasound ablation of uterine fibroids.Methods Sixty-three patients with uterine fibroids underwent CEUS before operation.The software of gray level measurement in JC HIFU system was used to obtain quantitative parameters of uterine fibroids perfusion.According to postoperative enhanced MR examination,the results were divided into satisfactory group (ablation rate≥70 ％) and partial ablation group (ablation rate＜ 70 ％).CEUS parameters of two groups were compared,and the correlation between parameters and ablation rate were analyzed.The predictive value was evaluated by ROC curve.Results There were significant differences in the time of arrival (AT),time to peak (TTP),enhancement time (ET),enhancement intensity (EI) and enhancement rate (ER) between the two groups (all P＜0.01).The AT,TTP and ET were positively correlated with the ablation rate (all P＜0.01),and the EI and ER were negatively correlated with the ablation rate (both P＜0.001).The area under the curve (AUC) of AT,TTP,ET,EI,ER were all greater than 0.7,among which ER had the highest predictive value (AUC-0.935).Using ER=5.23 as the cut-off point,the sensitivity of predicting ablation effect was 80.0％,specificity was 95.8％.Conclusion There is a certain correlation between the ultrasound ablation effect of uterine fibroids and the quantitative parameters of CEUS.ER can be used as a good predictor of ablation effect.
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Objective To explore the correlation between ultrasonographic characteristics and pathologic types of pediatric appendicitis.Methods 123 pediatric patients who were suspected of appendicitis meanwhile obtained ultrasonography scan and got final diagnosis were enrolled in this study.The characteristics of ultrasonograghy were analyzed,classified and compared with surgical and pathological results.Results All cases were confirmed by surgery and pathology.Appendicitis was comfirmed in 115 patients,including simple appendicitis in 3 cases,purulent appendicitis in 67 cases and gangrenous appendicitis in 45 cases.Appendicitis was diagnosed by ultrasonography in 114 patients and excluded in 9 patients.The sensitivity,specificity and accuracy of ultrasonography in diagnosis of appendicitis was 99.1％ (113/114),88.9 ％ (8/9),98.4 ％ (121 / 123),respectively.Ultrasonographic characteristics of pediatric appendicitis were correlated well with the pathologic types.Conclusion Ultrasonography has great value in diagnosis and classification of pediatric appendicitis.
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Objective To evaluate the efficacy and safety of focused ultrasound ablation in the treatment of submucosal fibroids which broke into uterine cavity less than 50%. Methods From Oct. 2006 to Sept. 2009, 66 patients with 69 submucosal fibroids broke into uterine cavity less than 50% diagnosed by MRI in Chinese People's Liberation Army General Hospital were enrolled in this study. They were treated by ultrasound-guided focused ultrasound ablation in the outpatient department, which using the contrast enhanced ultrasonography to assess the efficacy after ablation immediately, to measure reduction of fibroids volume and record adverse effect before and after ultrasound ablation. At 3, 6, 12 and 24 months after treatment, ablation outcome and fibroids volumes were evaluated by contrast ultrasound. The changes of clinical symptom were evaluated by the symptom severity score ( SSS) of the uterine fibroid quality-of-life instrument( UFS-QOL). Results The average volume of fibroids in 66 patients with 68 submucosal fibroids were (151 ±134) cm3 before treatment and (114 ± 104) cm3 no enhanced regional after treatment. The ablation rate of target fibroids was (77 ±16)%. All patients completed this treatment successfully, they were followed up for 6 - 44 months, the median follow-up time was 24 months. No serious complication was observed. However, there were 52% (34/66) patients presented vaginal discharge after ablation, it disappeared gradually after 3 to 4 menstrual cycles. The SSS and the menstrual period symptom scores were significantly lower than that before ablation at the follow-up of 3,6, 12 and 24 months, the rates were 20. 9% , 38. 0% , 45. 1% , 47. 1% and 42. 0% , 63. 8% , 64. 2% , 68. 8% , which all reached statistical difference (P ＜ 0. 05 ). The necrotic fibroids were absorbed gradually, the reduction rates of fibroid volume were 44. 7% ,66. 0% ,77. 7% and 89. 8% . Conclusion It was safe and efficacy that focused ultrasound ablation was used in treatment of submucosal fibroids which broke into the uterine less than 50%.
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Objective To explore the relationship between therapeutic dosage of ultrasound ablation in treatment of uterine fibroids and imaging characteristics of bloody supply of uterine fibroids by color Doppler ultrasound imaging. Methods One hundred and forty-two patients with 168 fibroids were treated by ultrasound ablation. Before treatment, bloody supply of fibroids were classified into grade 0 -4 by ultrasonography. Three patients lost follow-up with contrast MRI exam within 1 month after treatment, so 165 fibroids were enrolled in this study. Bloody supplies were 9 fibroids in grade 0, 34 fibroids in grade 1, 35 fibroids in grade 2, 55 fibroids in grade 3 and 32 fibroids in grade 4. After 1 month treatment, the treated area without blood supply and ratio of ablation were measured by contrast MRI to evaluate the efficacy of thermal ablation and compare status of blood supple based different therapeutic dosage. According to International Reditherapy for Society ( SIR ) standard, adverse effect and score of pain were evaluated. Results ( 1) Ratio of ablation based; ratios of ablation were 79% in grade 0, 89% in grade 1, 92% in grade 2, 86% in grade 3, 71% in grade 4. It reached statistical difference when blood supply of grade 0 compared with those of grade 2 and 3 (P ＜ 0. 05 ) and blood supply of grade 4 compared with those of grade 1, 2, 3 ( P ＜ 0. 05). (2) Factor of energy efficiency:factor of energy efficiency were 13.19 J/mm3 in degree 0, 9. 54 J/mm3 in degree 1, 12. 91 J/mm3 in degree 2, 17. 83 J/mm3 in degree 3 and 28. 10 J/mm in degree 4. Factor of energy of ablation in degree 4 was significantly higher than those in degree 1, 2 and 3 blood supply (P ＜ 0. 05). It exhibit the positive relationship between blood supply and factor of energy of ablation ( r = 0. 354 ,P ＜ 0. 01). ( 3 ) Score of pain and adverse effect: nearly 85% ( 120/142 ) patients could tolerate this treatment very well. Those scores of pain were in range of 0 to 4. All patients did not extend their hospitalization and C to F of SIR standard was not recorded. Conclusion blood supply of myoma measured by ultrasound could predict dosage of ultrasound ablation, it could help select indicated well patients.
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This study sought to find out whether the femoral artery of rabbit could be occluded after microbubbles mediated intermitten ultrasound exposure. One hundred and eight rabbits were randomly divided into 3 groups subjected to 3 different factors, namely ultrasound, HIFU combined with Microbubble (the intermitten mode and the continuous mode). After exposure, HE staining was used for visual inspection of the histopathologic change of femoral artery. Electron microscope was used for observation of the ultramicrostructural change; digital subtraction radiography (DSA) was used for inspections of the change in blood flow. There were thrombi formed in the femoral artery and the blood flow was occluded; the endarterium of the femoral artery of rabbits was damaged, and there was cavitation observed in the intermitten exposure group. In the other two groups, there was no change in the the femoral artery of rabbits. Thrombus could be formed in the femoral artery, and blood flow was occluded after exposure to microbubbles-mediated intermitten HIFU.
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Animales , Femenino , Masculino , Conejos , Velocidad del Flujo Sanguíneo , Efectos de la Radiación , Embolización Terapéutica , Métodos , Arteria Femoral , Patología , Efectos de la Radiación , Microburbujas , Flujo Sanguíneo Regional , Terapia por Ultrasonido , MétodosRESUMEN
Objective To establish an RP-HPLC method for the determination of β-Sitosterol in Elaeagnus Gonyanthes Benth. Methods The separation was performed on a luna C8 (2) (150 mm×4.6 mm, 5μm) column with the mobile phase of methanol-water (88∶12, v/v) at a flow rate of 1.0 mL/min, the detection wavelength was set at 210 nm, and the temperature of the column was maintained at 35 ℃. Results The calibration curve of β-Sitosterol was linear over the concentration range of 0.075-0.375 mg/mL (r=0.9999) and the average recovery of β-Sitosterol was 96.30% with RSD of 3.60%(n=3). Conclusion The method is simple, rapid, and accurate, and can be used for the quality control of Elaeagnus Gonyanthes Benth.
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Objective To investigate the safety and efficacy of ultrasound ablation in treatment of uterine fibroids. Methods Ninety-nine patients with 117 leiomyomas in total treated by Haifu JC focused ultrasound tumor therapeutic system were enrolled in prospective and non-randomized clinical trial in First Affiliated Hospital of Chongqing Medical University and Academy of Military Medical Sciences. Ultrasound ablation was performed guided by real-time ultrasonography under conscious sedation for single session. All patients were followed up at 6 months after treatment. On the day of treatment and after 1 month, patients were given by magnetic resonance imaging(MRI) exam to evaluate the effect of fibroids ablation. At 3 and 6months after treatment, the ratio of ablated area and volume reduction of fibroids more than 50% were evaluated by MRI exam again. The symptoms improvements were evaluated by uterine fibroid symptom (UFS) and complications were analyzed by guideline of society of international radiation (SIR). Results The average ablated area ratio of the target fibroid was (76 ± 24)%. The average reduction in fibroid volume determined by MRI at 3 and 6 months after treatment was (45 ± 21)% and (59 ± 26)%. Which were significantly decreased than those before treatment (P < 0. 05). At 6 months after treatment, 84. 6% (99/117) of patients showed more than 50% volume reduction, the rate of improved symptom score was 92%(66/72). All patients could resume normal daily activities at 2 hours after treatment. The adverse reactions of SIR C - D included delayed hospitalization, repeat treatment and increased level of nursing. E - F included permanent sequelae and death. In this study, no adverse reactions of C - F were recorded. Common complications (SIR A- B, only observation or simple management without sequelae) were 35% (35/99).Four cases with adverse reactions B of SIR were found, including 2 cases with skin burning of degree Ⅱ and 2 cases with febrile, they were administered by symptomatic therapy and changing dressing The other adverse reaction A of SIR included sorness of buttock, vaginal discharge, dysuria and painful urination, they were only suggested by follow-up. Conclusion It was efficacy and safe that ultrasound ablation as a single strategy were used in treatment of uterine fibroids.
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Objective To investigate the effects of low intensity pulsed ultrasound ( LIPU ) on articular car-tilage injury in rabbits. Methods Ten adult New Zealand white rabbits with bilateral, full-thickness osteochondral defects in the cartilage surfaces of intercondylar fossas were used as model. The left knees in these rabbits treated with LIPU were used as experimental group. The right knees treated with sham intervention were used as controls. All the rabbits were sacrificed at the 8th week postoperation for gross appearance grading, histological grading and semi-quan-titation of proteoglycan in the repairing tissue. Results Compared with controls, defects treated with LIPU im-proved significantly as shown by gross appearance grades, histological grades and optical density of toluidine blue at the 8th week postoperation (both P <0.05). Conclusion LIPU could accelerate repairing of articular cartilage in-jury.
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OBJECTIVE To study the influence of focused ultrasound on the morphology of nasal mucosa in sheep. METHODS A model CZB ultrasound therapeutic system for rhinitis, developed and produced by Chongqing Haifu(HIFU)Technology Co.,Ltd.,Chongqing China,was used in this study. Linear scans were performed on bovine liver in vitro under different scan parameters, and the biologic focal field(BFF)was detected to evaluate if it met the requirements of designed. The nasal mucosa of inferior turbinate of sheep was exposed with the same scan parameters under the observation of nasal endoscope, and morphological changes of the nasal mucosa were observed by gross examination, light and electron microscopes. RESULTS This study revealed that the designed biological focal field in bovine liver in vitro could be obtained under the scan parameters mentioned above. Linear scan with the same condition,there was no obvious change in appearance and color of the treated nasal mucosa in the inferior turbinate of the sheep. However,3 days after treatment,there was an increased secretion in the nasal cavity,which recovered 7 days post-treatment. Light microscopic examination 3 days after exposure showed that the epithelia of the nasal mucosa was intact and there was diffused distribution of spot coagulated necroses in the subepithelia layer of treated nasal mucosa. Degeneration of vascular endothelial cells and thrombosis of blood vessels were found in the coagulated necrosis region. Besides,degeneration or necrosis of nerve cells was induced,and glandular cells werepartially or completely damaged. The structure of epithelial goblet cells and ciliated cells in the treated nasal mucosa appeared to be normal under the observation of electronic microscope. At the seventh day after treatment,signs of tissue regeneration such as hyperplasia of collagen fiber were found in the coagulated region,and the necrosis tissue began to dissolve and was absorbed at the 14th day post-treatment. CONCLUSION Under the above scan parameters,the energy of focused ultrasound could be deposited specifically at the subepithelia layer,and to ablate the targeted nasal mucous tissues which are rich in blood vessels,nerves and glands. There were no damage to the non-target area such as epithelial layer,which could maintain the normal structure and biological function of mucociliary of nasal mucosa.
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[Objective]To assess the success of hallux valgus surgery of oblique and impaction osteotomy of first metatarsal neck.[Method]The outcome of 36 patients(45 feet)treated by this technique for symptomatic hallux valgus deformity was reviewed.The follow-up was two years.Lateral and AP radiographs were taken in a standing position pre-and postoperativly and hallux valgus angle(HV angle)and intermetatarsal angle(IM 1~2 angle)were measured accordingly.The efficacy of the surgery was evaluated by JOA scoring for foot disorders.[Result]The fracture healing was excellent.There was no case of delay union and nonunion.Two cases(three feet)were found to have superficial infection.The mean HV angle and IM 1~2 angle was revised by 15.6? and 4.2? respectively.JOA score was elevated for 29.6 points.[Conclusion]Hallux valgus can be corrected in three-dimension by the technique of first metatarsal neck osteotomy and inverted impaction fixation.
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Objective To study automatic drawing on target therapy area based on MRI and CT imagings in order to get the precision less than 1 mm in HIFU treatment.Methods Based on MRI and CT imagings,automatic image was recognized and the frame was extracted by image processing and image segmentation,etc..Results The system of software we are studying can be effectively used to recognize medical automatic images and get target therapy areas' image drawings.Conclusion This system of software will be used in medical precise treatment systems,such as HIFU 3D Treatment Regional Planning System.
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Objective:To explore the feasibility and stability of using oleic acid to establish acute respiratory distress syndrome(ARDS) model in Beagle dogs.Methods:A total of 25 Beagle dogs were injected oleic acid with a speed of 0.25?0.03ml/Kg through jugular vein after being anesthetized.The gas ventilation index,oxygen metabolism,histopathological changes,chest-ray scan and stability of each index after establishing the ARDS situation were continuously monitored and evaluated.Results:All 25 dogs were reached the diagnosis criteria of ARDS in 4.16?0.92 hours after injection of oleic acid,The arterial PaCO2 of the animals was 27.98?8.25mmHg,PaO2 was 65.40?11.48mmHg,and PaO2/FiO2 was 182.3?29.6.After mechanical ventilation treatment,PaO2/FiO2≤200.Pulmonary mesenchyme,and alveolus edema,bleeding,shrinkage and transparent formation were seen under microscope.There was darkness or coarse shadow in the lung by the X-ray scan.Conclusions:Through injection of oleic acid via jugular vein,a Beagle dog ARDS model may be quickly established with stable changes of hemodynamics,pulmonary mechanics and histology.
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Objective To study the common imaging characters of the human tissues such as tumors in MRI based on hysteromyoma in hope of getting the results that the same tissue has the same MR characters and identifying the common,comparatively steady MR figs sectional area which can provide related references for the computer-based automatic recognition orgnization and basis for the question such as whether the same MR figs has the same hyperacoustic impedance characters.Methods We analysed all the images with hysteromyoma on MRI T2 and got the rules on MR figs change with the application of the MRI image analysing software which specially designed by Microsoft Visual C++ 6.0 for the research.Results(1)No significant difference was found in MR figs sectional area in the different periods of the same patient under the same MRI test condition.(2)No significant difference was found in MR figs sectional area in different patients under the same MRI test condition.(3)Significant difference was found in MR figs sectional area after the patient received the HIFU treatment under the same MRI test condition.Conclusion(1)Human tissues have some common MRI imaging characters in the same MRI test equipment under the same MRI test condition.(2)Imaging characters of the human body tissues in MRI can be altered after HIFU treatment.
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<p><b>OBJECTIVE</b>To investigate the efficacy and side-effects of high intensity focused ultrasound (HIFU) in the treatment of malignant solid tumors.</p><p><b>METHODS</b>Thirty such patients who refused surgery and or refractory to chemotherapy, were treated by HIFU alone, with the efficacy and side effects monitored in terms of vital organ signs observation, functional assay of important organs, imaging examinations: digital subtraction angiography (DSA), CT, MRI, single photoemission computed tomography (SPECT), large core needle biopsy, complications or metastasis.</p><p><b>RESULTS</b>After HIFU therapy, the vital signs remained stable and the function of heart, lung, kidney and liver was also normal. DSA images showed that small or larger arteries were not damaged. After a follow-up of 10 - 38 months (23.1 months), 26 patients (87%) have been alive. The volume of the tumor underwent complete regression in 10 patients. Shrinkage of tumor volume >/= 50% was observed in 13. Eight of 13 patients were examined by large core needle biopsy, all showing necrosis and/or fibrosis though 3 patients (10%) had local recurrence. Two of these were retreated again by HIFU and the locally recurrent tumor became well controlled. New metastases developed in 5 patients after HIFU therapy. Two patients suffered from peripheral nerve injuries, most of which have recovered during the follow-up. However, one patient developed skin injury.</p><p><b>CONCLUSION</b>High intensity focused ultrasound alone is effective and safe in the treatment of malignant solid tumors.</p>
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Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias , Terapéutica , Resultado del Tratamiento , Ultrasonido Enfocado Transrectal de Alta IntensidadRESUMEN
<p><b>OBJECTIVE</b>To develop a new noninvasive limb-salvaging method in the treatment of primary malignant bone tumor in the extremities.</p><p><b>METHODS</b>Forty-four patients with primary malignant bone tumor were treated by extracorporal high intensity focused ultrasound (HIFU) with or without chemotherapy, with a mean follow-up of 17.6 months.</p><p><b>RESULTS</b>The overall survival and complication rates were 84.1% and 18.2%. In 34 patients with stage II b disease, 30 were disease-free, with 2 died of tumor metastasis to brain and lung and 3 developed local recurrence. In 10 patients with stage III b disease, 5 survived with tumor, with 1 developed local recurrence and 5 died of lung metastasis. Thirty-six of 44 patients were > or = 15 points by Enneking system.</p><p><b>CONCLUSION</b>High intensity focused ultrasound combined with chemotherapy for primary malignant bone tumor in the extremity is proved to be effective and safe, preserving good function in the limbs. HIFU may possibly become a new limb-salvaging treatment for this tumor.</p>
