Mala T, Edwin B, Samset E, Gladhaug I, Hol P K, Fosse E, Mathisen O, Bergan A, Søreide O
Surgical Department/ Interventional Center, National Hospital, Oslo, Norway.
Eur J Surg. 2001 Aug;167(8):610-7. doi: 10.1080/110241501753171227.
To study the feasibility of percutaneous cryoablation of hepatic tumours monitored by magnetic resonance imaging (MRI).
Prospective study
University hospital, Norway
Six patients with hepatic metastases from colorectal cancer.
Percutaneous cryoprobe positioning under general anaesthesia. Positioning and freezing monitored by near-real-time MRI using an open 0.5 Tesla MRI configuration system.
Safety and feasibility of the procedure. Measurement of volumes of cryolesions.
One patient developed a biliary leakage that had to be drained. Four patients developed pleural fluid. Two small tumours were adequately cryoablated. In the remaining 4 patients with large (>4 cm) tumours, an adequate cryolesion could not be formed. Cryolesion volumes larger than 105 cm3 were not produced even using 3-4 probes. MRI visualised the growing cryolesion well, but positioning of the cryoprobes was time-consuming.
MR guided cryoablation is clinically feasible and gives good visualisation of the procedure. Patients with small tumours (<3 cm) seem to be best suited to this percutaneous approach as cryolesion volumes claimed to be adequate for tumour destruction can be produced. Measurement of tumour volume preoperatively may help to select patients who will respond.
研究磁共振成像（MRI）监测下经皮冷冻消融肝肿瘤的可行性。
前瞻性研究
挪威大学医院
6例结直肠癌肝转移患者
全身麻醉下经皮放置冷冻探针。使用开放式0.5特斯拉MRI配置系统通过近实时MRI监测定位和冷冻过程。
该操作的安全性和可行性。测量冷冻损伤的体积。
1例患者发生胆漏，需进行引流。4例患者出现胸腔积液。2个小肿瘤被充分冷冻消融。其余4例肿瘤较大（>4cm）的患者未能形成足够的冷冻损伤。即使使用3 - 4根探针，也未产生大于105cm³的冷冻损伤体积。MRI能很好地显示不断增大的冷冻损伤，但冷冻探针的定位耗时。
磁共振引导下的冷冻消融在临床上是可行的，且该操作可视化良好。小肿瘤（<3cm）患者似乎最适合这种经皮方法，因为可以产生据称足以破坏肿瘤的冷冻损伤体积。术前测量肿瘤体积可能有助于选择有反应的患者。
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