Griffin Michael O, Kulkarni Naveen M, OʼConnor Stacy D, Sudakoff Gary S, Lea William B, Tutton Sean M
Divisions of Diagnostic Radiology.
Vascular and Interventional Radiology, Department of Radiology, Medical College of Wisconsin, Milwaukee, WI.
Ultrasound Q. 2019 Dec;35(4):346-354. doi: 10.1097/RUQ.0000000000000431.
Magnetic resonance-guided focused ultrasound (MRgFUS) utilizes high-intensity focused ultrasound to noninvasively, thermally ablate lesions within the body while sparing the intervening tissues. Magnetic resonance imaging provides treatment planning and guidance, and real-time magnetic resonance thermometry provides continuous monitoring during therapy. Magnetic resonance-guided focused ultrasound is ideally suited for the treatment of extra-abdominal desmoid fibromatosis due to its noninvasiveness, lack of ionizing radiation, low morbidity, and good safety profile. Conventional treatments for these benign tumors, including surgery, radiation, and chemotherapy, can carry significant morbidity. Magnetic resonance-guided focused ultrasound provides a safe and effective alternative treatment in this often-young and otherwise healthy patient population. While there is considerable experience with MRgFUS for treatment of uterine fibroids, painful bone lesions, and essential tremor, there are few reports in the literature of its use for treatment of benign or malignant soft tissue tumors. This article reviews the principles and biologic effects of high-intensity focused ultrasound, provides an overview of the MRgFUS treatment system and use of magnetic resonance thermometry, discusses the use of MRgFUS for the treatment of extra-abdominal desmoid tumors, and provides several case examples.
磁共振引导聚焦超声（MRgFUS）利用高强度聚焦超声对体内病变进行非侵入性热消融，同时保留其间的组织。磁共振成像提供治疗规划和引导，实时磁共振测温在治疗过程中提供持续监测。磁共振引导聚焦超声因其非侵入性、无电离辐射、低发病率和良好的安全性，非常适合治疗腹外硬纤维瘤病。这些良性肿瘤的传统治疗方法，包括手术、放疗和化疗，可能会带来显著的发病率。磁共振引导聚焦超声为这个通常年轻且其他方面健康的患者群体提供了一种安全有效的替代治疗方法。虽然在使用MRgFUS治疗子宫肌瘤、疼痛性骨病变和特发性震颤方面有相当多的经验，但文献中很少有关于其用于治疗良性或恶性软组织肿瘤的报道。本文回顾了高强度聚焦超声的原理和生物学效应，概述了MRgFUS治疗系统及磁共振测温的应用，讨论了MRgFUS用于治疗腹外硬纤维瘤的情况，并提供了几个病例实例。
