Traitement des lésions osseuses par Ultrasons Focalisés de Haute Intensité : de la simulation aux applications cliniques

Abstract : After a “state of art” on bone lesions ablation techniques, bone experimentations presented showed that deep focalisation allows the best lateral periosteal heating. On cement, from which the coefficient α was measured, the same thermic curves were observed. A simulation was done with two values of α (4.7 et 9.9 dB/cm). A higher heating at the periosteal focal point with superficial focalisation and a higher periosteal lateral heating with deep focalisation with a thermic inertia, were confirmed with simulation. Heating was higher with the high α value. A retrospective analysis of the bone lesions treated with minimally invasive treatment showed that 50% of osteoid osteomas and 35.7% of metastases were classified as suitable with MRgHIFU alone. 35.9% additional cases may have been treated with dissection or consolidation. At 1 MHz, US distortion due to the presence of needles in the US cone was observed only with the 13-gauge needle. However, if 18 to 22G needles may induce few distortion, an acoustic barrier may appear if the liquid injected flows in front of the US.
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Fabrice Bing. Traitement des lésions osseuses par Ultrasons Focalisés de Haute Intensité : de la simulation aux applications cliniques. Ingénierie biomédicale. Université de Strasbourg, 2018. Français. ⟨NNT : 2018STRAD045⟩. ⟨tel-02179447v2⟩

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