Kato A, Fujimoto Y, Hashimoto N, Taniguchi M, Kinoshita M, Hirayama A, Maruno M, Yoshimine T
Department of Neurosurgery, Osaka University Medical School, Japan.
Acta Neurochir (Wien). 2005 May;147(5):543-50; discussion 550. doi: 10.1007/s00701-005-0509-3. Epub 2005 Mar 31.
Image-guided and temperature-controlled radiofrequency thermal ablation techniques were applied to reduce tumor volume and relieve the symptoms caused by extracranial extension of recurrent meningioma.
We treated two patients with recurrent meningioma, an 81-year-old woman presenting with bulging of the temple and a 68-year-old woman presenting with visual disturbance, facial disfigurement, and sensory disturbance. Neuroimaging in both patients, revealed a large tumor extending extracranially and involving the infratemporal fossa. To avoid injury to important anatomical structures either compressed or entrapped by the tumor, the spatial relation between the planned ablation volume and these structures was confirmed by 3-D reconstruction of the ablation target. During the ablation procedure, local temperatures over the tissue being cauterized were continuously monitored to limit the ablation area to that within the planned volume adjusting RF power.
Radiofrequency ablation produced tumor necrosis as planned without adverse effects and resulted in swift relief of symptoms and signs with shrinkage of the tumor.
This technique may be an effective alternative for recurrent meningiomas extending extracranially and for which radical surgical procedures are not indicated.
应用图像引导和温度控制的射频热消融技术来减小肿瘤体积，并缓解复发性脑膜瘤颅外扩展所引起的症状。
我们治疗了两名复发性脑膜瘤患者，一名81岁女性表现为颞部膨隆，另一名68岁女性表现为视力障碍、面部畸形和感觉障碍。两名患者的神经影像学检查均显示有一个巨大肿瘤向颅外扩展并累及颞下窝。为避免损伤被肿瘤压迫或包绕的重要解剖结构，通过对消融靶点进行三维重建来确定计划消融体积与这些结构之间的空间关系。在消融过程中，持续监测被烧灼组织的局部温度，通过调整射频功率将消融区域限制在计划体积内。
射频消融按计划产生了肿瘤坏死，且无不良反应，肿瘤缩小，症状和体征迅速缓解。
对于颅外扩展且不适合进行根治性手术的复发性脑膜瘤，该技术可能是一种有效的替代方法。
