A performance analysis of an extracorporeal shock wave lithotripter: spatial pressure distribution and the effects of lithotripter voltage, electrode life, and tissue attenuation.

Abstract

The Dornier MPL-9000 lithotripter was analyzed as a function of lithotripter voltage, electrode efficiency, and bovine muscle attenuation. The maximum pressure at 20 kV measured 65 +/- 4 MPa (mean +/- SD). The region containing 50% of the maximum pressure was a cylindrical volume with a diameter of 2.5 cm and a height of 7 cm. Pressure varied in a linear fashion with lithotripter voltage (r = 0.996). The average pressure produced by an electrode throughout the course of 2,200 shock waves was 78% of its maximum pressure. Shock wave pressure was reduced from 65 +/- 4 MPa to 49 +/- MPa, 44 +/- 3 MPa, and 44 +/- 1 MPa with 1-, 2-, and 3-cm thickness of intervening bovine muscle, respectively. There was a statistically significant decrease in pressure when muscle was interposed, but there was no significant difference in reduction of pressure between 1, 2, and 3 cm of muscle (ANOVA, Newman-Keuls, alpha = 0.01). Frequency spectral analysis revealed the major contribution to the shock wave comes from 0-200 kHz with a peak near 50 kHz. Major frequency intensities were reduced with a decrease in lithotripter voltage, attenuating tissue, and distance away from the center of the focal zone.