Mailpoint 053, Clinical Radiology Department, Southampton General Hospital, Southampton, UK.
Cardiovasc Intervent Radiol. 2010 Oct;33(5):896-908. doi: 10.1007/s00270-010-9892-0. Epub 2010 Jun 11.
Renal cell carcinoma is a common malignancy causing significant mortality. In recent years abdominal imaging, often for alternate symptomatology, has led the trend toward the detection and confirmation of smaller renal tumors. This has permitted the greater use of localized and nephron-sparing techniques including partial nephrectomy and image-guided ablation. This article aims to review the current role of image-guided biopsy and ablation in the management of small renal tumors. The natural history of renal cell carcinoma, the role of renal biopsy, the principles and procedural considerations of thermal energy ablation, and the oncological outcomes of these minimally invasive treatments are discussed and illustrated with cases from the authors' institution. Image-guided ablation, in particular, has changed the treatment paradigm and, by virtue of its increasingly evident efficacy and low morbidity, now favors the treatment of smaller tumors in patients previously unfit for surgery.
肾细胞癌是一种常见的恶性肿瘤，可导致较高的死亡率。近年来，腹部影像学检查（通常是为了检查其他症状）的应用趋势导致了更小的肾肿瘤的检测和确诊。这使得局部治疗和保留肾单位技术（包括部分肾切除术和影像引导下消融术）的应用更为广泛。本文旨在综述影像引导下活检和消融术在小肾肿瘤治疗中的作用。本文讨论了肾细胞癌的自然病程、肾活检的作用、热消融的原则和程序考虑因素，以及这些微创治疗的肿瘤学结局，并结合作者所在机构的病例进行了说明。特别是影像引导下消融术已经改变了治疗模式，由于其疗效日益明显且发病率低，现在更有利于治疗以前不适合手术的患者的较小肿瘤。
