title: The impact of microbubble-enhanced therapeutic ultrasound combined with prothrombin on microwave ablation in the rabbit liver.
abstract: OBJECTIVE
  This study aimed to investigate the effect of microbubble-enhanced ultrasound (MEUS) combined with prothrombin on regional hepatic circulation and microwave ablation (MWA) in rabbit livers.
  
  
  METHODS
  High-pressureamplitude therapeutic ultrasound (TUS) was used to treat 52 surgically exposed livers of healthy New Zealand rabbits: 13 livers were treated with MEUS alone, 13 with MEUS and prothrombin (PMEUS), 13 with ultrasound plus normal saline and 13 with ultrasound plus prothrombin as controls. Contrast-enhanced ultrasound (CEUS) imaging was performed on the exposed livers before and after treatment, and acoustic quantification was done to assess liver perfusion. Then, the liver was divided into two parts, one was used for pathologic examination and the other was ablated with microwave (MWA) and then processedfor pathologic examination.
  
  
  RESULTS
  The CEUS images and Peak value after treatment in the PMEUS group were significantly reduced as compared to the remaining 3 groups (p<0.05). Occasional piecemeal hemorrhage was evidenced in the pathological examination in the MEUS group. Obvious cellular degeneration and necrosis with thrombosis were observed in the PMEUS group. Electron microscopy showed endothelial damage in both the MEUS group and PMEUS group. After MWA, coagulated volumes (V) in the PMEUS group were larger than in the remaining 3 groups (p<0.05). The cell ultrastructure disorder wasmore severe in the PMEUS group than in remaining 3 groups.
  
  
  CONCLUSIONS
  PMEUS promotes endothelial injury and produces more obvious thrombotic occlusion, improving the therapeutic effect of MWA on the rabbit liver.
authors.affiliation: Department of Ultrasound, Xijing Hospital, Fourth Military Medical University, Xi'an, Department of Ultrasound, the Second Hospital of Shanxi Medical University, Taiyuan, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Shi
authors.affiliation: Department of Ultrasound, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
authors.forename: Xinyue
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Cardiology, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
authors.forename: Zhenli
authors.initials: Z
authors.lastname: Luo
authors.affiliation: Department of Ultrasound, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
authors.forename: Fen
authors.initials: F
authors.lastname: Gu
authors.affiliation: Department of Ultrasound, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
authors.forename: Jianguo
authors.initials: J
authors.lastname: He
authors.affiliation: Department of Biochemistry and Molecular Biology, Shanxi Medical University, Taiyuan, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Yan
authors.affiliation: Department of Gastroenterology, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
authors.forename: Junwang
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Ultrasound, Xijing Hospital, Fourth Military Medical University, Xi'an, China. zhouxd1@sina.com.
authors.forename: Xiaodong
authors.initials: X
authors.lastname: Zhou
mesh_terms: D000818:Animals; D017115:Catheter Ablation / Q000379:methods*; D003131:Combined Modality Therapy / Q000379:methods; D008099:Liver / Q000098:blood supply / Q000187:drug effects* / Q000473:pathology / Q000601:surgery*; D008102:Liver Circulation / Q000187:drug effects / Q000528:radiation effects; D008872:Microwaves / Q000627:therapeutic use; D010743:Phospholipids / Q000627:therapeutic use*; D011516:Prothrombin / Q000008:administration & dosage*; D011817:Rabbits; D013459:Sulfur Hexafluoride / Q000627:therapeutic use*; D016896:Treatment Outcome; D014464:Ultrasonic Therapy / Q000379:methods*
chemical_list: D010743:Phospholipids; C420843:contrast agent BR1; D011516:Prothrombin; D013459:Sulfur Hexafluoride