The impact of microbubble-enhanced therapeutic ultrasound combined with prothrombin on microwave ablation in the rabbit liver.

Abstract

This study aimed to investigate the effect of microbubble-enhanced ultrasound (MEUS) combined with prothrombinon regional hepatic circulation and microwave ablation (MWA) in rabbit livers. High-pressureamplitude therapeutic ultrasound (TUS) was used to treat 52 surgically exposed livers of healthy New Zealand rabbits: 13 liverswere treated with MEUS alone, 13 with MEUS and prothrombin (PMEUS), 13 with ultrasound plus normal saline and 13with ultrasound plus prothrombin as controls. Contrast-enhanced ultrasound (CEUS) imaging was performed on the exposedlivers before and after treatment, and acoustic quantification was done to assess liver perfusion. Then, the liver was dividedinto two parts, one was used for pathologic examination and the other was ablated with microwave (MWA) and then processedfor pathologic examination. The CEUS images and Peak value after treatment in the PMEUS group were significantlyreduced as compared to the remaining 3 groups (p<0.05). Occasional piecemeal hemorrhage was evidenced in the pathologicalexamination in the MEUS group. Obvious cellular degeneration and necrosis with thrombosis were observed in the PMEUSgroup. Electron microscopy showed endothelial damage in both the MEUS group and PMEUS group. After MWA, coagulatedvolumes (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. PMEUS promotes endothelial injury and producesmore obvious thrombotic occlusion, improving the therapeutic effect of MWA on the rabbit liver.