Boss A, Clasen S, Kuczyk M, Anastasiadis A, Schmidt D, Claussen C D, Schick F, Pereira P L
Abteilung Diagnostische Radiologie, Eberhard-Karls-Universität, Tübingen.
Rofo. 2005 Aug;177(8):1139-45. doi: 10.1055/s-2005-858320.
First results of a study about the efficacy of magnetic resonance-(MR-)guided radiofrequency ablation of renal cell carcinomas (RCC) are presented.
Eight patients (63 to 82 years old) with RCC up to 3.9 cm in diameter were treated by percutaneous RF ablation under MR-guidance in an open MR scanner at 0.2T field strength. For positioning of the RF-electrode, fluoroscopic rapid gradient echo sequences (acquisition time about 2 sec) were used. The ablation was monitored by intermittent imaging with T1- and T2-weighted spin echo sequences.
In each patient, the applicator was successfully positioned within the tumor using MR-guidance. Seven of eight patients were completely treated within one single session; one patient had to be retreated for tumor relapse at 13 months. The mean number of electrode repositionings under MR guidance for complete ablation was 2.0; ablation time ranged between 12 and 28 minutes. Maximum diameter (volume) of induced coagulation necrosis within one session was 3.9 cm (30.2 cm (3)) by using cluster electrodes. With single electrodes, maximum short axis diameter of coagulation without repositioning was 2.4 cm (11.6 cm (3)). All patients are now disease-free after a mean follow up of 13 months (5 to 21 months). No major complications occurred during or after the ablation procedure.
MR-guided RF ablation in an open interventional 0.2T MR-unit is a safe and effective modality for the treatment of RCC. Fast MR-imaging is a convenient method for exact positioning of MR-compatible RF-electrodes. Near on-line MR-monitoring of ablation procedure with T2-weighted imaging allows for immediate assessment of the coagulation extent.
介绍一项关于磁共振（MR）引导下射频消融肾细胞癌（RCC）疗效的研究的初步结果。
8例直径达3.9 cm的RCC患者（年龄63至82岁）在0.2T场强的开放式MR扫描仪中接受MR引导下的经皮射频消融治疗。使用透视快速梯度回波序列（采集时间约2秒）进行射频电极定位。通过T1加权和T2加权自旋回波序列的间歇性成像监测消融过程。
在每位患者中，使用MR引导成功将施源器置于肿瘤内。8例患者中有7例在单次治疗中得到完全治疗；1例患者在13个月时因肿瘤复发需再次治疗。MR引导下完全消融的电极重新定位平均次数为2.0次；消融时间在12至28分钟之间。使用集束电极时，单次治疗中诱导的凝固性坏死的最大直径（体积）为3.9 cm（30.2 cm³）。使用单电极时，未重新定位的凝固的最大短轴直径为2.4 cm（11.6 cm³）。所有患者在平均随访13个月（5至21个月）后均无疾病。消融过程中及术后未发生重大并发症。
在开放式介入性0.2T MR设备中进行MR引导下的射频消融是治疗RCC的一种安全有效的方法。快速MR成像对于MR兼容的射频电极的精确定位是一种便捷的方法。使用T2加权成像对消融过程进行近乎在线的MR监测可立即评估凝固范围。
