Comparison of electrohydraulic lithotripters with rigid and pressure-release ellipsoidal reflectors. I. Acoustic fields.

The most common lithotripter, a Dornier HM-3, utilizes an underwater spark to generate an acoustic pulse and a rigid ellipsoidal reflector to focus the pulse on the kidney stone to be comminuted. The pulse measured in water with a PVDF membrane hydrophone at the external focus of the ellipsoid was a 1-microsecond positive-pressure spike followed by a 3-microsecond negative-pressure trough. When we replaced the rigid reflector in our experimental lithotripter with a pressure-release reflector, the pulse was a 1.6-microsecond trough followed by a 0.6-microsecond positive spike. The waveforms are nearly time inverses (i.e., their spikes and troughs are reversed). The frequency spectra, the maximum peak positive pressures P+ (42 MPa, rigid and 43 MPa, pressure-release), and the maximum peak negative pressures P- (-12 MPa and -14 MPa) are comparable. The maximum P- occurred 20 mm closer to the reflector than did the maximum P+, for both reflectors. However, the spatial maxima of the peak pressures (P+ and P-) produced by the pressure-release reflector were located 20 mm nearer to the reflector than those produced by the rigid reflector. Qualitative explanation of the waveforms and the location of pressure maxima as well as comparison to previous theoretical and experimental results is given. The alternate waveform produced by the pressure-release reflector may be a tool in determining the role of cavitation in lithotripsy because cavitation is highly sensitive to waveform.