Barkhausen Jörg, Kahn Thomas, Krombach Gabriele A, Kuhl Christiane K, Lotz Joachim, Maintz David, Ricke Jens, Schönberg Stefan O, Vogl Thomas J, Wacker Frank K
Department of Radiology and Nuclear Medicine, University Hospital Schleswig Holstein Luebeck Campus, Germany.
Clinic and Policlinic for Diagnostic and Interventional Radiology, Leipzig, Germany.
Rofo. 2017 Jul;189(7):611-623. doi: 10.1055/s-0043-110011. Epub 2017 Jun 26.
MRI is attractive for the guiding and monitoring of interventional procedures due to its high intrinsic soft tissue contrast and the possibility to measure physiologic parameters like flow and cardiac function. The current status of interventional MRI for the clinical routine was analyzed. The effort needed for the development of MR-safe monitoring systems and instruments initially resulted in the application of interventional MRI only for procedures that could not be performed by other means. Accordingly, biopsy of lesions in the breast, which are not detectable by other modalities, has been performed under MRI guidance for decades. Currently, biopsies of the prostate under MRI guidance are established in a similar fashion. At many sites blind biopsy has already been replaced by MR-guided biopsy or at least by the fusion of MR images with ultrasound. Cardiovascular interventions are performed at several centers for ablation as a treatment for atrial fibrillation. Interventional MRI has been established in the clinical routine for a variety of indications. Broader application can be expected in the clinical routine in the future owing to the multiple advantages compared to other techniques. · Due to the significant technical effort, MR-guided interventions are only recommended in the long term for regions in which MRI either facilitates or greatly improves the intervention.. · Breast biopsy of otherwise undetectable target lesions has long been established in the clinical routine. Prostate biopsy is currently being introduced in the clinical routine for similar reasons. Other methods such as MR-guided focused ultrasound for the treatment of uterine fibroids or tumor ablation of metastases represent alternative methods and are offered in many places.. · Endovascular MR-guided interventions offer advantages for a number of indications and have already been clinically established for the treatment of children with congenital heart defects and for atrial ablation at individual centers. Greater application can be expected in the future.. · Barkhausen J, Kahn T, Krombach GA et al. White Paper: Interventional MRI: Current Status and Potential for Development Considering Economic Perspectives, Part 1: General Application. Fortschr Röntgenstr 2017; 189: 611 - 623.
由于磁共振成像（MRI）具有较高的固有软组织对比度，且能够测量诸如血流和心功能等生理参数，因此在介入操作的引导和监测方面具有吸引力。本文分析了介入性MRI在临床常规应用中的现状。最初，开发磁共振安全监测系统和仪器所需的努力使得介入性MRI仅应用于其他方法无法进行的操作。因此，几十年来一直在MRI引导下对乳腺中其他检查手段无法检测到的病变进行活检。目前，MRI引导下的前列腺活检也以类似方式得以确立。在许多部位，盲目活检已被MR引导活检或至少被MR图像与超声融合所取代。多个中心开展了心血管介入消融治疗心房颤动。介入性MRI已在临床常规中用于多种适应症。与其他技术相比，由于其具有多种优势，预计未来在临床常规中会有更广泛的应用。· 由于技术难度较大，长期来看，MR引导的介入操作仅推荐用于MRI能够促进或极大改善介入操作的区域。· 乳腺中其他检查手段无法检测到的目标病变的活检早已在临床常规中确立。出于类似原因，前列腺活检目前正在引入临床常规。其他方法，如MR引导聚焦超声治疗子宫肌瘤或转移瘤消融，代表了替代方法，在许多地方都有提供。· 血管内MR引导的介入操作在许多适应症方面具有优势，并且已经在临床上用于治疗先天性心脏病儿童和个别中心的心房消融。预计未来会有更广泛的应用。· 巴克豪森J，卡恩T，克罗姆巴赫GA等。白皮书：介入性MRI：从经济角度考虑的现状和发展潜力，第1部分：一般应用。《Fortschr Röntgenstr》2017年；189：611 - 623。
