High Intensity Ultrasound in Gastroenterology

描述（由申请人提供）：急性消化道出血是治疗性内镜检查的常见适应症。有几种内镜止血方法，包括热疗法（加热探头、电灼、氩等离子凝固和激光）、注射疗法和机械装置（绑扎、夹子和可拆卸环）。虽然有几种治疗胃肠道出血的装置和方法，但对于大出血、恶性溃疡性肿瘤出血和胃肠道壁深部血管出血等情况，止血装置的发展仍然需要取得进展。高强度聚焦超声（HIFU）是一种治疗消化道出血的新方法。应用于组织的HIFU可导致HIFU换能器焦点内的温度在1秒内快速上升接近100xC，而不会损坏中间组织。这种热效应是由于声波能量的吸收组织在一个小的焦点体积，由于聚焦超声光束类似于放大镜聚焦阳光。在被认为是由于热凝的动物模型中，HIFU已被证明可以实现被刺穿的动脉和静脉的止血。我们对撕裂的兔耳静脉和动脉进行了初步止血研究，表明HIFU可能对治疗急性消化道出血有效。提出了一种适合于内镜下HIFU输送的探针，随后在有胃肠道出血的大型动物体内进行研究。预计这项工作将有助于更好地了解HIFU的机制及其在其他胃肠道应用（如肿瘤治疗）中的潜在作用。

DESCRIPTION (provided by applicant): Acute GI bleeding is a common indication for therapeutic endoscopy. Several methods of endoscopic hemostasis are available including thermal therapy (heater probes, electrocautery, argon plasma coagulation, and lasers), injection therapy, and mechanical devices (band ligation, clips, and detachable loops). Although several devices and methods for treating gastrointestinal bleeding exist, advances in the development of hemostatic devices are still needed for situations such as massive bleeding, bleeding from malignant ulcerated tumors, and bleeding arising from vessels located deep within the GI wall. High-intensity focused ultrasound (HIFU) represents a new method that may have applications in treating gastrointestinal bleeding. HIFU applied to tissue can result in a rapid rise in temperature approaching 100xC in 1 second within the focus of the HIFU transducer without damaging the intervening tissue. This thermal effect is due to absorption of acoustic energy by tissue in a small focal volume due to focusing of the ultrasound beam similar to a magnifying glass focusing sunlight. HIFU has been demonstrated to achieve hemostasis in punctured arteries and veins in animals models thought to be due to thermal coagulation. We have performed initial hemostasis studies in lacerated rabbit auricular veins and arteries that suggest HIFU may be effective in the treatment of acute GI bleeding. The development of a probe suitable for the endoscopic delivery of HIFU followed by in vivo studies in large animals with GI bleeding is proposed. It is anticipated that this work will help to gain a better understanding of the mechanisms of HIFU and its potential role for other GI applications such as tumor therapy.