Experimental Study Of The Impact Of Prothrombin Combined With Cavitation Of Microbubbles On Blocking Regional Hepatic Micrangium In Rabbits

Objective:Primary liver cancer is one of the most common malignant tumors. Its morbidity and mortality is increasing year by year, which makes a serious harm to human health. Ultrasound-guided thermal ablation therapy is one of the main methods of minimally invasive treatment for primary liver cancer. How to improve the efficiency of thermal ablation and to reduce the treatment risk of specific parts are a hot research topic around the world in recent years. This experiment explores the effect of the prothrombin combined with microbubble cavitation on blocking and damaging regional hepatic micrangium in rabbits, and the effect on blocking and damaging regional hepatic micrangium in rabbits in different peak negative pressures of cavitation. The experiment explores an effective way to reduce thermal subsidence effects, improve treatment effect and reduce the recurrence rate of the thermal ablation therapy.Methods:The experimental rabbits were divided into 4 groups in the first part of the experiment, including the physiological saline group, the prothrombin group, the cavitation of microbubbles group, and the prothrombin combined with cavitation of microbubbles group. By comparing the CEUS imaging effects, the CEUS quantitative analysis of gray-scale value(GSV), the statistics analysis, and the pathological examination results, this part of the experiment studies on the different effects on blocking and damaging regional hepatic micrangium in rabbits. The second part of the experiment divided rabbits into 6groups, including the cavitation only group, the cavitation of microbubbles group, and the prothrombin combined with cavitation of microbubbles group. These three groups use two different peak negative pressures consisting of 3.75 MPa and 5.00 MParespectively. The different effects on blocking and damaging regional hepatic micrangium in rabbits were studied. Results:In the first part of the experiment, no significant changes were showed in physiological saline group and prothrombin group. Both cavitation of microbubbles group and prothrombin combined with cavitation of microbubbles group showed defects in the contrast filtration of CEUS images.This effect was more obvious in prothrombin combined with cavitation of microbubbles group.Cavitation of microbubbles group showed occasional piecemeal hemorrhage area. Prothrombin combinedwith cavitation of microbubbles group showed obvious cellular degeneration and necrosis with micro-thrombosis.GSV of cavitation of microbubbles groupreduced from 62.94±6.19 to 36.36±7.30(P<0.05). GSV of prothrombin combined with cavitation of microbubbles group decreased from 63.52±8.53 to 22.91±5.39 significantly(P<0.05). GSV change showed statistical difference between prothrombin combined with cavitation of microbubbles group and cavitation of microbubbles group(t=13.996, P<0.05).In the second part of the experiment, cavitation only group showed no significant change. Both cavitation of microbubbles group and prothrombin combinedwith cavitation of microbubbles group showed defects in the contrast filtration of CEUS images, and this effect was more obvious in prothrombin combined with cavitation of microbubbles group.Pathological outcome of cavitation of microbubbles group showed part of liver cell edema with local small hemorrhages, while prothrombin combined with cavitation of microbubbles group showed obvious hydropic degeneration and necrosis with the formation of micro-thrombosis. GSV of cavitation of microbubbles group with 3.75 MPa decreased from60.99±6.23 to 38.23±9.29(P<0.05). GSV of cavitation of microbubbles group with 5.00 MPa reduced from 65.57±6.53 to 33.39±7.09(P<0.05). The comparison of these two groups was statistically significant(t=6.676, P<0.05).GSV of prothrombin combined with cavitation of microbubbles group with 3.75 MPadecreased from 61.23±8.21 to 25.38±7.17(P<0.05).GSV of prothrombin combined with cavitation of microbubbles group with 5.00 MPa reduced from 65.78±5.35 to 21.04±6.49(P<0.05). And the comparison of these two groups was statistically significant(t=10.488, P<0.05). Conclusion:Prothrombin combined with cavitation of microbubbles can significantly damage the micrangium and block the regional hepatic flow perfusion in rabbits. And the blocking effect is positively correlated with the peak negative pressure of cavitation.