Department of Interventional Radiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China.
Biomed Res Int. 2021 May 13;2021:5537192. doi: 10.1155/2021/5537192. eCollection 2021.
Percutaneous tumor ablation is usually performed using computed tomography (CT) or ultrasound (US) guidance, although reliable visualization of the target tumor could be challenging. Magnetic resonance- (MR-) guided ablation provides more reliable visualization of the target tumors and allows multiplanar imaging of the treatment process, making it the modality of choice, in particular if lesions are small.
From March 2016 to January 2018, 32 patients scheduled for percutaneous treatment of T1 RCC underwent MR-guided MWA. Complications were classified according to the Clavien grade. Kaplan-Meier survival estimates were calculated to evaluate progression-free survival (PFS).
Technical success was achieved in all lesions. The mean energy and procedure duration were 61.6 ± 8.7 kJ and 118.2 ± 26.7 min, respectively. The glomerular filtration rate (GFR) dropped rapidly after 1 month of treatment and slowly recovered within three months ( < 0.05). Postoperative pain and fever were the most common adverse events after treatment. Perirenal hematoma, thermal injury of the psoas muscle, and abdominal distension were common complications after MWA, and the incidence rates were 9.4% (3/32), 6.3% (2/32), and 6.3% (2/32), respectively. According to the Clavien grade classification, serious complications include hydrothorax, bowel injury, and renal failure, all of which have a probability of 3.1%. Of note, the three serious complications occurred in one patient. The 1-, 2-, and 3-year PFS rates were 96.9%, 93.8%, and 83.9%, respectively. The mean PFS rates were 33.972 months (95% CI: 33.045, 35.900).
Microwave ablation is feasible under MR guidance and provides effective treatment of RCC in one session.
经皮肿瘤消融术通常采用计算机断层扫描（CT）或超声（US）引导进行，尽管目标肿瘤的可靠可视化可能具有挑战性。磁共振引导的消融（MR 引导消融）提供了更可靠的目标肿瘤可视化，并允许治疗过程的多平面成像，使其成为首选方式，特别是对于小病变。
2016 年 3 月至 2018 年 1 月，32 例计划行经皮治疗 T1 期 RCC 的患者接受了 MR 引导下 MWA。并发症根据 Clavien 分级进行分类。使用 Kaplan-Meier 生存估计评估无进展生存率（PFS）。
所有病变均获得技术成功。平均能量和手术时间分别为 61.6±8.7kJ 和 118.2±26.7min。肾小球滤过率（GFR）在治疗后 1 个月迅速下降，3 个月内缓慢恢复（<0.05）。术后疼痛和发热是治疗后最常见的不良事件。肾周血肿、腰大肌热损伤和腹胀是 MWA 后常见的并发症，发生率分别为 9.4%（3/32）、6.3%（2/32）和 6.3%（2/32）。根据 Clavien 分级分类，严重并发症包括血胸、肠损伤和肾衰竭，其概率均为 3.1%。值得注意的是，这三种严重并发症均发生在一位患者身上。1、2、3 年的 PFS 率分别为 96.9%、93.8%和 83.9%。平均 PFS 率为 33.972 个月（95%CI：33.045，35.900）。
MR 引导下微波消融是可行的，可为 RCC 提供单次有效治疗。
