Harada J, Dohi M, Mogami T, Fukuda K, Miki K, Furuta N, Kishimoto K, Simizu T, Miyasaka K
Department of Radiology, Jikei University School of Medicine, Kashiwa Hospital, Chiba, Japan.
Radiat Med. 2001 Nov-Dec;19(6):291-6.
The aim of this study was to obtain preliminary results of cryoablation of renal tumors by using a percutaneous approach guided by a horizontal open MRI system, and to assess the safety and efficacy of this procedure.
Four patients with renal tumors underwent percutaneous cryosurgery with local anesthesia using a horizontal open MRI system (AIRIS II, Hitachi Medical Corp., Tokyo, Japan). The size of the mass was radiographically documented as 4 cm or less in diameter. A 2- or 3-mm cryoprobe was advanced into the renal mass under real-time MR monitoring. Growth of the iceball during cryoablation was monitored by two-dimensional MR images. Follow-up dynamic CT and physical examination were done after two weeks and six weeks.
MR imaging demonstrated the iceballs as sharply marginated regions of signal loss that expanded and engulfed the renal mass with clear contrast between the iceball and surrounding tissue. Cryoablated tumors resolved, and there were no serious complications and no clinically significant changes during the procedures and follow-up study.
In this limited clinical trial of percutaneous renal tumor surgery, cryoablation demonstrated its feasibility with minimal morbidity. Intraprocedual MR-guided cryosurgery can be used as a safe modality, although further studies are necessary to determine the long-term efficacy of this procedure.
本研究旨在获得在水平开放式MRI系统引导下经皮冷冻消融肾肿瘤的初步结果，并评估该手术的安全性和有效性。
4例肾肿瘤患者在局部麻醉下使用水平开放式MRI系统（AIRIS II，日本东京日立医疗公司）接受经皮冷冻手术。影像学记录肿块直径为4 cm或更小。在实时MR监测下将2或3 mm的冷冻探针推进到肾肿块中。冷冻消融期间通过二维MR图像监测冰球的生长。术后两周和六周进行随访动态CT检查和体格检查。
MR成像显示冰球为信号丢失的边界清晰区域，其扩大并包绕肾肿块，冰球与周围组织之间对比清晰。冷冻消融的肿瘤消退，手术过程及随访研究期间未出现严重并发症及具有临床意义的变化。
在这项经皮肾肿瘤手术的有限临床试验中，冷冻消融显示出其可行性且发病率极低。术中MR引导下的冷冻手术可作为一种安全的方式，尽管需要进一步研究以确定该手术的长期疗效。
