MRI引导下聚焦超声消融腰内侧支神经：猪模型的可行性和安全性研究
MRI-guided focused ultrasound ablation of lumbar medial branch nerve: Feasibility and safety study in a swine model.
作者信息
Kaye Elena A, Monette Sebastien, Srimathveeravalli Govindarajan, Maybody Majid, Solomon Stephen B, Gulati Amitabh
机构信息
a Department of Medical Physics , Memorial Sloan Kettering Cancer Center , New York ;
b Tri-Institutional Laboratory of Comparative Pathology, Memorial Sloan Kettering Cancer Center , Rockefeller University, Weill Cornell Medical College , New York ;
出版信息
Int J Hyperthermia. 2016 Nov;32(7):786-94. doi: 10.1080/02656736.2016.1197972. Epub 2016 Jul 21.
Abstract
PURPOSE
About 10-40% of chronic low back pain cases involve facet joints, which are commonly treated with lumbar medial branch (MB) radiofrequency neurotomy. Magnetic resonance imaging-guided focused ultrasound (MRgFUS), a non-invasive, non-ionising ablation modality used to treat tumours, neuropathic pain and painful bone metastasis can also be used to disrupt nerve conduction. This work's purpose was to study the feasibility and safety of direct MRgFUS ablation of the lumbar MB nerve in acute and subacute swine models.
MATERIALS AND METHODS
In vivo MRgFUS ablation was performed in six swine (three acute and three subacute) using a clinical MRgFUS system and a 3-T MRI scanner combination. Behavioural assessment was performed, and imaging and histology were used to assess the treatment.
RESULTS AND CONCLUSIONS
Histological analysis of the in vivo studies confirmed thermal necrosis of the MB nerve could be achieved without damaging the spinal cord or adjacent nerve roots. MRgFUS did not cause changes in the animals' behaviour or ambulation.
摘要
目的
约10%-40%的慢性下腰痛病例涉及小关节，通常采用腰内侧支（MB）射频神经切断术进行治疗。磁共振成像引导聚焦超声（MRgFUS）是一种用于治疗肿瘤、神经性疼痛和疼痛性骨转移的非侵入性、非电离消融方式，也可用于破坏神经传导。本研究的目的是在急性和亚急性猪模型中研究直接MRgFUS消融腰MB神经的可行性和安全性。
材料与方法
使用临床MRgFUS系统和3-T MRI扫描仪组合，对六只猪（三只急性和三只亚急性）进行体内MRgFUS消融。进行行为评估，并使用成像和组织学评估治疗效果。
结果与结论
体内研究的组织学分析证实，可实现MB神经的热坏死，而不会损伤脊髓或相邻神经根。MRgFUS未引起动物行为或行走的改变。
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