A review of the ultrasonic bioeffects of microsonation, gas-body activation, and related cavitation-like phenomena.

Ultrasonic exposures localized to regions smaller than a wavelength minimize the thermal mechanism, but promote nonthermal mechanisms of ultrasonic bioeffects. Microsonation experiments with vibrating needles or wires exploit this situation for the study of nonthermal mechanisms such as acoustic microstreaming flow. Shear stress in microstreaming flow, which is in excess of critical values for biomembranes, leads to cell lysis. Plane wave exposure of small bodies of gas also yields localized exposure, with further amplification of nonthermal mechanisms by resonance activation of oscillation. Gas body activation in vitro causes gathering of suspended cells by radiation forces, aggregation, cellular effects and lysis by microstreaming. When suitable gas bodies are present, these effects may occur at levels below the threshold for ultrasonic cavitation. In vivo, gas body activation generates intracellular microstreaming in Elodea leaves and disrupts the cells for super-critical shear stress levels. Similar phenomena seem to account for cell death, growth and mitotic index reductions in other plant tissues, and developmental abnormalities and delayed death in fruit flies. Only fragmentary and equivocal evidence presently exists on the medically relevant question of whether such subthreshold cavitation-like activity and bioeffects occur in vertebrates.