Scipione Roberto, Anzidei Michele, Bazzocchi Alberto, Gagliardo Cesare, Catalano Carlo, Napoli Alessandro
Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
Department of Radiology, Rizzoli Orthopedic Institute, University of Bologna, Bologna, Italy.
Semin Intervent Radiol. 2018 Oct;35(4):261-267. doi: 10.1055/s-0038-1673363. Epub 2018 Nov 5.
High-intensity focused ultrasound (HIFU) is a totally noninvasive procedure that has shown promising results in the management of numerous malignant and nonmalignant conditions. Under magnetic resonance or ultrasound guidance, high-intensity ultrasound waves are focused on a small, well-defined target region, inducing biologic tissue heating and coagulative necrosis, thus resulting in a precise and localized ablation. This treatment has shown both great safety and efficacy profiles, and may offer a multimodal approach to different diseases, providing pain palliation, potential local tumor control, and, in some cases, remineralization of trabecular bone. In musculoskeletal field, HIFU received FDA approval for treating bone metastasis, but its application has also been extended to other conditions, such as osteoid osteoma, desmoid tumor, low-flow vascular malformation, and facet joint osteoarthritis. This article illustrates the basic principles of HIFU and its main effects on biologic tissues with particular attention on bone, provides a step-by-step description of the HIFU procedure, and discusses the commonly treated conditions, in particular bone metastases.
高强度聚焦超声（HIFU）是一种完全无创的治疗方法，已在多种恶性和非恶性疾病的治疗中显示出有前景的结果。在磁共振或超声引导下，高强度超声波聚焦于一个小的、界限清晰的目标区域，引起生物组织发热和凝固性坏死，从而实现精确的局部消融。这种治疗方法已显示出良好的安全性和有效性，并且可能为不同疾病提供多模式治疗方法，缓解疼痛、实现潜在的局部肿瘤控制，在某些情况下还可使小梁骨再矿化。在肌肉骨骼领域，HIFU已获得美国食品药品监督管理局（FDA）批准用于治疗骨转移，但其应用也已扩展到其他疾病，如骨样骨瘤、硬纤维瘤、低流量血管畸形和小关节骨关节炎。本文阐述了HIFU的基本原理及其对生物组织（特别是骨骼）的主要影响，逐步介绍了HIFU治疗过程，并讨论了常见的治疗疾病，尤其是骨转移。
