Basic study of less invasive high-intensity focused ultrasound (HIFU) in fetal therapy for twin reversed arterial perfusion (TRAP) sequence

J Med Ultrason (2001). 2016 Oct;43(4):487-92. doi: 10.1007/s10396-016-0725-x. Epub 2016 Jun 9.

Abstract

Purpose: The objective of the present study was to develop a high-intensity focused ultrasound (HIFU) transducer more suitable for clinical use in fetal therapy for twin reversed arterial perfusion (TRAP) sequence.

Materials and methods: We created a cooling and degassed water-circulating-type HIFU treatment device. HIFU was applied to renal branch vessels in three rabbits. Sequential HIFU irradiation contains a trigger wave, heating wave, and rest time. The duration of HIFU application was 10 s/course. Targeting could be achieved by setting the imaging probe in the center and placing the HIFU beam and imaging ultrasonic wave on the same axis.

Result: We confirmed under sequential HIFU irradiation with a total intensity of 1.94 kW/cm(2) (spatial average temporal average intensity) that the vein and artery were occluded in all three rabbits.

Conclusion: Simultaneous occluding of the veins and arteries was confirmed with trigger waves and a resting phase using the HIFU transducer treatment device created for this study. Clinical application appears possible and may represent a promising option for fetal therapy involving TRAP sequence.

Keywords: Fetal therapy; Flow occlusion; HIFU; TRAP sequence.

MeSH terms

  • Animals
  • Equipment Design
  • Female
  • Fetal Therapies / instrumentation*
  • Fetal Therapies / methods*
  • Fetofetal Transfusion / therapy*
  • High-Intensity Focused Ultrasound Ablation / instrumentation*
  • High-Intensity Focused Ultrasound Ablation / methods*
  • Kidney / blood supply
  • Pregnancy
  • Rabbits
  • Renal Artery / diagnostic imaging
  • Renal Artery / pathology
  • Renal Artery / surgery
  • Renal Veins / diagnostic imaging
  • Renal Veins / pathology
  • Renal Veins / surgery
  • Ultrasonography, Doppler, Color