Jagannathan Jay, Sanghvi Narendra T, Crum Lawrence A, Yen Chun-Po, Medel Ricky, Dumont Aaron S, Sheehan Jason P, Steiner Ladislau, Jolesz Ferenc, Kassell Neal F
Department of Neurological Surgery, University of Virginia Health Sciences Center, Charlottesville, Virginia 22902, USA.
Neurosurgery. 2009 Feb;64(2):201-10; discussion 210-1. doi: 10.1227/01.NEU.0000336766.18197.8E.
The field of magnetic resonance imaging-guided high-intensity focused ultrasound surgery (MRgFUS) is a rapidly evolving one, with many potential applications in neurosurgery. The first of 3 articles on MRgFUS, this article focuses on the historical development of the technology and its potential applications in modern neurosurgery. The evolution of MRgFUS has occurred in parallel with modern neurological surgery, and the 2 seemingly distinct disciplines share many of the same pioneering figures. Early studies on focused ultrasound treatment in the 1940s and 1950s demonstrated the ability to perform precise lesioning in the human brain, with a favorable risk-benefit profile. However, the need for a craniotomy, as well as the lack of sophisticated imaging technology, resulted in limited growth of high-intensity focused ultrasound for neurosurgery. More recently, technological advances have permitted the combination of high-intensity focused ultrasound along with magnetic resonance imaging guidance to provide an opportunity to effectively treat a variety of central nervous system disorders. Although challenges remain, high-intensity focused ultrasound-mediated neurosurgery may offer the ability to target and treat central nervous system conditions that were previously extremely difficult to address. The remaining 2 articles in this series will focus on the physical principles of modern MRgFUS as well as current and future avenues for investigation.
磁共振成像引导下的高强度聚焦超声手术（MRgFUS）领域发展迅速，在神经外科有许多潜在应用。作为关于MRgFUS的3篇文章中的第一篇，本文重点介绍该技术的历史发展及其在现代神经外科中的潜在应用。MRgFUS的发展与现代神经外科并行，这两个看似不同的学科有许多相同的先驱人物。20世纪40年代和50年代对聚焦超声治疗的早期研究表明，能够在人脑中进行精确的损伤，且风险效益比良好。然而，由于需要开颅手术以及缺乏先进的成像技术，神经外科高强度聚焦超声的发展受到限制。最近，技术进步使得高强度聚焦超声与磁共振成像引导相结合，为有效治疗各种中枢神经系统疾病提供了机会。尽管挑战依然存在，但高强度聚焦超声介导的神经外科手术可能提供针对和治疗以前极难处理的中枢神经系统疾病的能力。本系列的其余2篇文章将重点介绍现代MRgFUS的物理原理以及当前和未来的研究途径。
