Nour Sherif Gamal, Lewin Jonathan S
Department of Radiology, University Hospitals of Cleveland, 11100 Euclid Avenue, Cleveland, OH 44106, USA.
Magn Reson Imaging Clin N Am. 2005 Aug;13(3):561-81. doi: 10.1016/j.mric.2005.04.007.
Performing RFA procedures under MR imaging involves two distinct processes: interactive guidance of the RF electrode into the targeted tumor and monitoring the effect of therapy. The justification for using MR imaging for electrode guidance is quite similar to its use to guide biopsy and aspiration procedures, where MR imaging offers advantages related to superior soft tissue contrast, multiplanar capabilities, and high vascular conspicuity that facilitate safe and accurate guidance in selected lesions. The major contribution of MR imaging to thermal ablation procedures is its ability to monitor tissue changes associated with the heating process instantaneously, an attribute that is not paralleled by any other currently available imaging modality. Such ability facilitates a controlled approach to ablation by helping to detect inadequately treated tumor foci for subsequent interactive repositioning of the RF electrode during therapy. As such, MR imaging guidance and monitoring enable treatment of the entire tumor on a single-visit basis while avoiding undue overtreatment and preserving often critically needed organ function. Although knowledge of interventional MR imaging concepts and familiarity with its technology and with the related safety issues are indispensable for interventional radiologists attempting thermal ablation procedures in the MR imaging environment, understanding the tissue basis of necrosis imaging is becoming an essential part of the knowledge base for the larger sector of general radiologists who are required to interpret the follow-up MR imaging scans of the increasing number of thermal ablation patients.
在磁共振成像（MR）引导下进行射频消融（RFA）操作涉及两个不同的过程：将射频电极交互式引导至目标肿瘤以及监测治疗效果。使用MR成像进行电极引导的理由与用于引导活检和抽吸操作十分相似，在这些操作中，MR成像具有优势，包括软组织对比度高、多平面成像能力以及血管显示清晰，有助于在特定病变中进行安全准确的引导。MR成像对热消融操作的主要贡献在于其能够即时监测与加热过程相关的组织变化，这一特性是目前任何其他成像方式都无法比拟的。这种能力通过在治疗过程中帮助检测治疗不充分的肿瘤病灶，以便随后对射频电极进行交互式重新定位，从而促进了一种可控的消融方法。因此，MR成像引导和监测能够在单次就诊时对整个肿瘤进行治疗，同时避免过度治疗，并保留常常至关重要的器官功能。尽管对于在MR成像环境中尝试进行热消融操作的介入放射科医生来说，了解介入性MR成像概念、熟悉其技术以及相关安全问题是必不可少的，但对于需要解读越来越多热消融患者后续MR成像扫描结果的广大普通放射科医生而言，理解坏死成像的组织基础正成为知识库的重要组成部分。
