Tsoumakidou Georgia, Buy Xavier, Garnon Julien, Enescu Julian, Gangi Afshin
Department of Nonvascular Interventional Radiology, University Hospital of Strasbourg, France.
Tech Vasc Interv Radiol. 2011 Sep;14(3):170-6. doi: 10.1053/j.tvir.2011.02.009.
A variety of thermal ablation techniques have been advocated for percutaneous tumor management. Although the above techniques are considered safe, they can be complicated with unintended thermal injury to the surrounding structures, with disastrous results. In the present article we report a number of different insulation techniques (hydrodissection, gas dissection and balloon interposition, warming/cooling systems) that can be applied. Emphasis is given to the procedure-related details, and we present the advantages and drawbacks of the insulation techniques. We also provide tips on avoiding painful skin burns when treating superficial lesions. Finally, we point out the interest of temperature monitoring and how it can be achieved (use of thermocouples, fiberoptic thermosensors, or direct magnetic resonance imaging temperature mapping). The above thermal insulation and temperature monitoring techniques can be applied alone or in combination. Familiarity with these techniques is essential to avoid major complications and to increase the indications of thermal ablation procedures.
多种热消融技术已被提倡用于经皮肿瘤治疗。尽管上述技术被认为是安全的，但它们可能会因意外热损伤周围结构而变得复杂，导致灾难性后果。在本文中，我们报告了一些可应用的不同隔离技术（水分离、气体分离和球囊置入、加热/冷却系统）。重点介绍了与操作相关的细节，并阐述了隔离技术的优缺点。我们还提供了治疗浅表病变时避免皮肤灼痛的小贴士。最后，我们指出了温度监测的意义以及实现方法（使用热电偶、光纤温度传感器或直接磁共振成像温度映射）。上述热隔离和温度监测技术可单独应用或联合应用。熟悉这些技术对于避免重大并发症和扩大热消融手术的适应症至关重要。
