2011-08-012024-05-13https://scholars.lib.ntu.edu.tw/handle/123456789/646517摘要：超音波顯影劑，直到利用特殊保護殼層，包裹微小氣泡之技術問世後，才開始 有廣泛的研究。其乃利用微氣泡對聲波的強烈散射，在靜脈注射微氣泡到體内循 環後，則可在目標組織來突顯出週遭的對比。目前研究多應用於肝膽、腎臟與心 血管領域，於骨胳肌肉系統的方面則付之闕如。而肌腱病變，乃是骨胳肌肉系統 中最常見疾患，組織學上包含膠原纖維斷裂、肌腱細胞增生與新生血管。而超音 波下的成像，則呈現局部低回音、喪失纖維平行排列、肌腱增厚與血流顯像增加。 雖然組織學上，可在慢性的肌腱病變組織觀察到豐富的新生血管，但依目前儀器 的敏感度，僅在急性發炎期時，能備測到血流增加，而慢性期時，因血管細小與 流速緩慢，反而在超音波下呈現低血管密度。由於肌腱病變内的新生血管，乃是 受傷組織復原的重要關鍵，目前因缺乏敏感的觀察工具而難以評估。因此本三年 期的研究計晝中，預計第一年利用本研究室的慢性肌腱炎模型，觀察是否可因超 音波顯影劑的加入，有效偵測出原本無法觀察的細微血管或新生血管。第二年則 運用在人體疾患上，觀察以往被認為是低血管密度的病變，如肱骨外上髁炎與足 底筋膜炎，是否因顯影劑的注射，能呈現肌腱内微細血流，並與其他超音波成像 做相關性研究。第三年則將此用來評估在震波治療前後，肌腱内血流是否產生改 變，進而研究新生血管在肌腱癒合的過程中所扮演的角色。<br> Abstract: Ultrasound contrast agent had never been applied on clinical research until thedevelopment of technology that wrapped microbubbles within protective shells.Microbubbles can enhance the contrast of the target tissue due to increased scatteringafter ultrasound beams emitting against bubbles. Current studies focus primarily onthe fields of hepatic, renal and cardiac applications, but rarely muscular-skeletalsystems. Tendinopathy is the most common muscular-skeletal disorder, whosehistology includes disruption of collagen fibers, tenocyte proliferation andneovasculization. Under sonographic exams, the diseased tendon appears hypoechoic,loss of fibrillar arrangement, focal thickening and increased vascularity. Althoughabundant micro-vessels or neovascularization can be observed in histologicalspecimens of chronic tendinopathy, increased vascularity can only be observed inacute inflammatory stage under sonography. It presents hypovascular echo-texture inchronic stage, probably due to lack of sensitive tools to detect tiny vessels. Thesevessels may play an important role in the healing process of tendinopathy but aredifficult to be evaluated. Thus in the first year of our research proposal, ultrasoundcontrast agent will be used to detect neovasulization in animal models with chronictendinopathy. In the second year, contrast agent will be applied on patients with lateralepicondylitis or plantar fasciitis. The correlated studies will also be conducted withclinical symptoms and other sonographic findings. In the third year, the technique willbe used to assess the change of vascularity in tissues with tendinopathy before andafter shockwave therapy􀀡in order to clarify the role of neovasculization for shockwavetherapy on tendinoapthy.肌腱炎超音波顯影劑都卜勒超音波震波tendinopathyultrasound contrast agentDopplershock wave