Urinary stone erosion and fragmentation under low-intensity quasi-collimated ultrasound using gas-filled microbubbles with stone-targeting lipid shells
Journal of the Acoustical Society of America(2018)
摘要
Urinary stone lithotripsy critically depends on the presence of cavitation nuclei at the stone surface. We hypothesized that introduction of stone-targeting microbubbles could increase cavitation activity at a stone surface sufficiently to allow stone erosion and fragmentation at peak negative pressures much lower than in acoustic energy-based urinary stone interventions with induced cavitation nuclei alone. Gas-filled microbubbles were produced with calcium-binding moieties incorporated into an encapsulating lipid shell. Stone surface coverage with these targeting microbubbles was found to approach an optimal (considering microbubble expansion during insonation) range of 5–15% with incubation times of three minutes or less. Using high-speed photomicroscopy, we observe bound microbubbles expanding 10- to 30-fold under insonation with quasi-collimated sources at mechanical indexes below 1.9. For observed stand-off parameters in the range of 0.2–0.6, the modeled collapse-generated shockwaves exceed 100 MPa....
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