Destruction de parenchyme hépatique par ultrasons focalisés

Objective. - High intensity focused ultrasound (HIFU) is an effective and precise method of focal tumoral destruction since it is associated with imagery. This method is widespread for the endorectal treatment of prostatic adenocarcinomas. HIFU seem appropriate for the treatment of liver tumors but its use needs to be experimentally tested in vivo. The aim of the work is to study the feasibility, tolerance and effectiveness of the destruction of porcine liver by HIFU. Material and methods. - Ten pigs had liver destruction by HIFU after coeliotomy. Four to 5 2,3 cm³ HIFU lesions were performed per animal under ultrasonographic control. The study included biological surveillance and an autopsy was performed 4 to 24 hours later for histological examination of the liver. Results. - The destruction of the liver was feasible in all cases and the 4 lobes of the liver could be treated. The general and biological tolerance of the procedure was excellent. Ultrasonographic features of the HIFU lesions were defined. The histological examination of the lesions showed well-circumscribed necrosis areas associated with cavitation or histological deficiencies of various degrees. Conclusion. - This work demonstrated that liver destruction by HIFU is a feasible and effective method with low morbidity. A long-term experimental study is necessary before comtemplating its clinical use.