Kiefer Ryan M, Stavropoulos S William
Department of Radiology, Division of Interventional Radiology, Hospital of University of Pennsylvania Medical Center, 1 Silverstein, 3400 Spruce St., Philadelphia, PA, 19104, USA.
Curr Urol Rep. 2017 May;18(5):36. doi: 10.1007/s11934-017-0687-6.
Although benign, renal angiomyolipoma (AML) may lead to serious complications without appropriate management. The purpose of this review is to describe the role of and evidence for interventional radiology techniques in the management of patients with AML.
For patients with renal masses and non-diagnostic imaging studies, image-guided percutaneous biopsy is found to be highly accurate and useful in directing patient management. Once the diagnosis of AML has been made based on either imaging or biopsy, arterial embolization of tumors that are symptomatic or >4 cm has been demonstrated to reduce the risk of hemorrhage as well as tumor size. Percutaneous ablation devices have been proposed as alternative strategies but remain investigational. The utility of interventional radiology techniques including percutaneous core needle biopsy and prophylactic super-selective arterial embolization is safe and effective management strategies for patients presenting with AML tumors.
肾血管平滑肌脂肪瘤(AML)虽为良性肿瘤,但若管理不当可能导致严重并发症。本综述旨在描述介入放射学技术在AML患者管理中的作用及相关证据。
对于肾肿物且影像学检查无法确诊的患者,影像引导下经皮穿刺活检在指导患者管理方面具有高度准确性和实用性。一旦基于影像学或活检确诊为AML,对于有症状或直径>4 cm的肿瘤进行动脉栓塞已被证明可降低出血风险并减小肿瘤大小。经皮消融设备已被提议作为替代策略,但仍处于研究阶段。包括经皮芯针活检和预防性超选择性动脉栓塞在内的介入放射学技术,对于AML肿瘤患者而言是安全有效的管理策略。