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 Nov;189(11):1047-1054. doi: 10.1055/s-0043-112336. Epub 2017 Sep 1.
MRI is attractive for guiding and monitoring interventional procedures due to its high intrinsic soft tissue contrast and the possibility to measure flow and cardiac function. Technical solutions have been developed for all procedural steps including imaging guidance, MR-safe catheters and instruments and patient monitoring. This has led to widening of the clinical applications. Interventional MRI is becoming increasingly important for the treatment of patients suffering from malignant diseases. The detectability of masses and consequently their accessibility for biopsy is higher, compared to other modalities, due to the high intrinsic soft tissue contrast of MRI. Temperature-dependent sequences allow for minimally invasive and tissue-sparing ablation (A-0 ablation). Interventional MRI has become established in the clinical routine for a variety of indications, including biopsies and tumor ablation. Since the economic requirement of covering costs by reimbursement is met and interventional MRI decreases the mortality and morbidity of interventional procedures, broader application of interventional MRI can be expected in the clinical routine in the future. · Particularly for the treatment of oncological patients, interventional MRI is superior to other methods with respect to minimal invasiveness and tissue protection due to the ability to exactly determine tumor borders and to visualize and control the size of the ablation area on the basis of MR temperature measurement.. · Due to the better visualization of targets and the effects of ablation in tissue, interventional MRI can lower the mortality and morbidity associated with these interventions for many indications.. · The complex comparison of costs and reimbursement shows that this application can be performed in a cost-covering manner and broader 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 2: Liver and Other Applications in Oncology. Fortschr Röntgenstr 2017; 189: 1047 - 1054.
由于其高内在软组织对比度以及测量血流和心脏功能的可能性,磁共振成像(MRI)在引导和监测介入性操作方面具有吸引力。针对包括成像引导、磁共振安全导管和器械以及患者监测在内的所有操作步骤,已经开发出了技术解决方案。这导致了临床应用范围的扩大。介入性MRI在恶性疾病患者的治疗中变得越来越重要。由于MRI具有高内在软组织对比度,与其他模态相比,肿块的可检测性更高,因此更容易进行活检。温度依赖序列允许进行微创和保留组织的消融(A-0消融)。介入性MRI已在临床常规中用于多种适应症,包括活检和肿瘤消融。由于满足了通过报销覆盖成本的经济要求,并且介入性MRI降低了介入性操作的死亡率和发病率,预计未来介入性MRI将在临床常规中得到更广泛的应用。·特别是对于肿瘤患者的治疗,介入性MRI在微创性和组织保护方面优于其他方法,因为它能够精确确定肿瘤边界,并基于磁共振温度测量可视化和控制消融区域的大小。·由于在组织中对靶点和消融效果的可视化更好,介入性MRI可以降低许多适应症下与这些干预相关的死亡率和发病率。·成本与报销的复杂比较表明,这种应用可以以成本覆盖的方式进行,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2部分:肝脏和肿瘤学中的其他应用。《Fortschr Röntgenstr》2017年;189:1047 - 1054。