The significance of membrane changes in the safe and effective use of therapeutic and diagnostic ultrasound

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Abstract
The exposure of cells and tissues to medical ultrasound can cause membrane changes which can affect cell behaviour. Although some of these changes could be of therapeutic benefit, in relieving pain and stimulating regeneration and repair, others could be deleterious if they were to occur during development. Since cavitation seems to be involved in producing membrane changes, it is recommended that the levels of ultrasound used diagnostically should be kept below the cavitation threshold. This will vary according to local environmental conditions. More information is needed on the conditions under which cavitation can occur in vivo, particularly in body fluids such as interstitial or tissue fluid, cerebrospinal and amniotic fluid, lymph and blood, before thresholds for cavitation can be stated with confidence. Meanwhile, in the interests of ensuring that ultrasound continues to be used safely, it is recommended that particular caution be exercised in its use during the embryonic period, when early histogenesis is occurring, that is, during the first 8 weeks of development, in line with the recommendations of the Medical Research Council (1985). It is during this period that membrane changes are of crucial importance in controlling subsequent development.