Ultrasound-Guided Intravascular Sonothrombolysis With a Dual Mode Ultrasound Catheter: In Vitro Study.
Ultrasound-Guided Intravascular Sonothrombolysis With a Dual Mode Ultrasound Catheter: In Vitro Study.
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DOI：
10.1109/tuffc.2022.3153929
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发表时间：
2022-06
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除非得到控制，血管中的血栓栓塞症通常会导致中风或心脏病发作，甚至猝死。基于超声造影剂的超声溶栓治疗在血栓栓塞症的有效治疗中显示出良好的效果。血管内超声溶栓换能器最近被报道在体外进行前所未有的超声溶栓。然而，在临床应用中，为了达到最佳的治疗效果，有必要在溶栓治疗过程中提供影像指导。本文研制了一种由16 MHz高频元件(成像换能器)和220 kHz低频元件(治疗换能器)组成的体外超声溶栓双模超声导管。治疗换能器采用20层PZT-5A叠层，孔径尺寸为1.2×1.2mm2，成像换能器的孔径尺寸为1.2×1.2mm2。两个换能器都被组装成定制的双腔10Fr导管。用牛血凝块进行体外实验。成像实验表明，对于16 MHz成像换能器，后向散射信号具有较高的信噪比。超声溶栓成功，治疗30min后血栓体积明显缩小。用16MHzM型超声心动图清晰观察溶栓过程中血栓大小的变化。结果表明，超声引导下血管内超声溶栓可以得到加强，因为由于成像引导，治疗换能器的位置可以随着凝块处的靶点而调整。
Thromboembolism in vessels often leads to stroke or heart attack and even sudden death unless brought under control. Sonothrombolysis based on ultrasound contrast agents has shown promising outcome in effective treatment of thromboembolism. Intravascular sonothrombolysis transducer was reported recently for unprecedented sonothrombolysis in vitro. However, it is necessary to provide an imaging guide during thrombolysis in clinical applications for optimal treatment efficiency. In this paper, a dual mode ultrasound catheter was developed combining a 16 MHz high frequency element (imaging transducer) and a 220 kHz low frequency element (treatment transducer) for sonothrombolysis in vitro. The treatment transducer was designed with a 20 layer PZT-5A stack with aperture size of 1.2 × 1.2 mm2 and the imaging transducer with the aperture size of 1.2 × 1.2 mm2 was attached in front of the treatment transducer. Both transducers were assembled into a customized two-lumen 10 Fr catheter. In vitro experiment was carried out using bovine blood clot. Imaging tests were conducted showing that the backscattering signals can be obtained with a high signal-to-noise (SNR) ratio for the 16 MHz imaging transducer. Sonothrombolysis was performed successfully that the volume of clot was reduced significantly after the 30 min of treatment. The size changes of clot were observed clearly using the 16 MHz M-mode imaging during the thrombolysis. The findings suggest that the proposed ultrasound-guided intravascular sonothrombolysis can be enhanced since the position of treatment transducer can be adjusted with the target at the clot due to the imaging guide.