Clasen Stephan, Boss Andreas, Schmidt Diethard, Schraml Christina, Fritz Jan, Schick Fritz, Claussen Claus D, Pereira Philippe L
Department of Diagnostic Radiology, University Hospital, Eberhard-Karls-University, Tübingen, Germany.
J Magn Reson Imaging. 2007 Oct;26(4):1043-52. doi: 10.1002/jmri.21120.
To evaluate the feasibility and technique effectiveness of magnetic resonance (MR)-guided radiofrequency (RF) ablation of hepatic malignancies.
In 64 patients, 100 primary (N = 19) or secondary (N = 81) liver tumors (mean diameter = 24.7 mm; range = 4-60 mm) were treated with 87 sessions of MR-guided RF ablation. The entire ablation procedure was carried out at an 0.2-T open MR system by using MR-compatible internally cooled electrodes. T2-weighted turbo spin echo sequences (TR/TE = 3500 msec/110 msec) were used to monitor thermally induced coagulation. Technique effectiveness was assessed four months after the last RF ablation by dynamic MR imaging at 1.5-T.
MR-guided RF ablation procedures were technical successful in 85 of 87 (97.7%) assessed at the end of each session. Complete coagulation was intended in 99 of 100 tumors. Technique effectiveness was observed in 92 of 99 (92.9%) of these tumors. To achieve complete coagulation 82 of 92 (89.1%) tumors required a single session. T2-weighted sequences were accurate to monitor the extent of coagulation and were supportive to guide overlapping ablation. There were two of 87 (2.3%) major and seven of 87 (8.0%) minor complications.
MR-guided RF ablation is a safe and effective therapy in the treatment of hepatic malignancies. MR imaging offers an accurate monitoring of thermally-induced coagulation, thus enabling complete tumor coagulation in a single session.
评估磁共振（MR）引导下射频（RF）消融治疗肝脏恶性肿瘤的可行性和技术有效性。
64例患者共100个原发性（n = 19）或继发性（n = 81）肝肿瘤（平均直径 = 24.7 mm；范围 = 4 - 60 mm）接受了87次MR引导下的RF消融治疗。整个消融过程在0.2 T开放式MR系统中使用与MR兼容的内部冷却电极进行。采用T2加权快速自旋回波序列（TR/TE = 3500 msec/110 msec）监测热诱导凝固。在最后一次RF消融后4个月，通过1.5 T动态MR成像评估技术有效性。
在每次消融结束时评估的87次MR引导下RF消融手术中，85次（97.7%）技术成功。100个肿瘤中有99个旨在实现完全凝固。这些肿瘤中有92个（92.9%）观察到技术有效性。为实现完全凝固，92个肿瘤中的82个（89.1%）需要单次消融。T2加权序列可准确监测凝固范围，并有助于指导重叠消融。87次手术中有2次（2.3%）发生严重并发症，7次（8.0%）发生轻微并发症。
MR引导下RF消融是治疗肝脏恶性肿瘤的一种安全有效的方法。MR成像可准确监测热诱导凝固，从而在单次消融中实现肿瘤完全凝固。
