title: Liver haemostasis using microbubble-enhanced ultrasound at a low acoustic intensity.
abstract: OBJECTIVE
  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/cm(2). 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.
  
  
  CONCLUSIONS
  • 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.
authors.affiliation: Department of Ultrasound, Xinqiao Hospital, The Third Military Medical University, Chongqing 400037, China.
authors.forename: Xiaochen
authors.initials: X
authors.lastname: Zhao
authors.forename: Lu
authors.initials: L
authors.lastname: Li
authors.forename: Hongzhi
authors.initials: H
authors.lastname: Zhao
authors.forename: Tao
authors.initials: T
authors.lastname: Li
authors.forename: Shengzheng
authors.initials: S
authors.lastname: Wu
authors.forename: Yu
authors.initials: Y
authors.lastname: Zhong
authors.forename: Yang
authors.initials: Y
authors.lastname: Zhao
authors.forename: Zheng
authors.initials: Z
authors.lastname: Liu
mesh_terms: D000162:Acoustics; D000818:Animals; D003287:Contrast Media / Q000494:pharmacology; D006470:Hemorrhage / Q000473:pathology / Q000628:therapy*; D006487:Hemostasis; D022781:Hepatocytes / Q000473:pathology; D008099:Liver / Q000000981:diagnostic imaging* / Q000473:pathology; D008107:Liver Diseases / Q000000981:diagnostic imaging* / Q000628:therapy*; D045423:Microbubbles; D009336:Necrosis; D011817:Rabbits; D014159:Transducers; D014464:Ultrasonic Therapy / Q000379:methods*; D014465:Ultrasonics / Q000379:methods*; D014463:Ultrasonography
chemical_list: D003287:Contrast Media