Turbulent water coupling in shock wave lithotripsy.
Journal Article (Journal Article)
Previous studies have demonstrated that stone comminution decreases with increased pulse repetition frequency as a result of bubble proliferation in the cavitation field of a shock wave lithotripter (Pishchalnikov et al 2011 J. Acoust. Soc. Am. 130 EL87-93). If cavitation nuclei remain in the propagation path of successive lithotripter pulses, especially in the acoustic coupling cushion of the shock wave source, they will consume part of the incident wave energy, leading to reduced tensile pressure in the focal region and thus lower stone comminution efficiency. We introduce a method to remove cavitation nuclei from the coupling cushion between successive shock exposures using a jet of degassed water. As a result, pre-focal bubble nuclei lifetime quantified by B-mode ultrasound imaging was reduced from 7 to 0.3 s by a jet with an exit velocity of 62 cm s(-1). Stone fragmentation (percent mass <2 mm) after 250 shocks delivered at 1 Hz was enhanced from 22 ± 6% to 33 ± 5% (p = 0.007) in water without interposing tissue mimicking materials. Stone fragmentation after 500 shocks delivered at 2 Hz was increased from 18 ± 6% to 28 ± 8% (p = 0.04) with an interposing tissue phantom of 8 cm thick. These results demonstrate the critical influence of cavitation bubbles in the coupling cushion on stone comminution and suggest a potential strategy to improve the efficacy of contemporary shock wave lithotripters.
Full Text
Duke Authors
Cited Authors
- Lautz, J; Sankin, G; Zhong, P
Published Date
- February 7, 2013
Published In
Volume / Issue
- 58 / 3
Start / End Page
- 735 - 748
PubMed ID
- 23322027
Pubmed Central ID
- PMC3693448
Electronic International Standard Serial Number (EISSN)
- 1361-6560
Digital Object Identifier (DOI)
- 10.1088/0031-9155/58/3/735
Language
- eng
Conference Location
- England