Department of Radiology and Biomedical Imaging, University of California, San Francisco, California.
Department of Anesthesia and Perioperative Care, University of California, San Francisco, California.
Semin Musculoskelet Radiol. 2021 Dec;25(6):725-734. doi: 10.1055/s-0041-1735472. Epub 2021 Dec 22.
Magnetic resonance-guided focused ultrasound (MRgFUS) is a novel noninvasive therapy that uses focused sound energy to thermally ablate focal pathology within the body. In the United States, MRgFUS is approved by the Food and Drug Administration for the treatment of uterine fibroids, palliation of painful bone metastases, and thalamotomy for the treatment of essential tremor. However, it has also demonstrated utility for the treatment of a wide range of additional musculoskeletal (MSK) conditions that currently are treated as off-label indications. Advantages of the technology include the lack of ionizing radiation, the completely noninvasive technique, and the precise targeting that offer unprecedented control of the delivery of the thermal dose, as well as real-time monitoring capability with MR thermometry. In this review, we describe the most common MSK applications of MRgFUS: palliation of bone metastases, treatment of osteoid osteomas, desmoid tumors, facet arthropathy, and other developing indications.
磁共振引导聚焦超声（MRgFUS）是一种新型的无创治疗方法，利用聚焦声能对体内的焦点病变进行热消融。在美国，磁共振引导聚焦超声已获得美国食品和药物管理局批准，用于治疗子宫肌瘤、缓解骨转移引起的疼痛，以及丘脑切开术治疗原发性震颤。然而，它还在治疗广泛的其他肌肉骨骼（MSK）疾病方面显示出了效用，这些疾病目前被视为超适应证治疗。该技术的优点包括无电离辐射、完全非侵入性技术以及精确的靶向性，为热剂量的传递提供了前所未有的控制，并且具有磁共振测温的实时监测能力。在这篇综述中，我们描述了磁共振引导聚焦超声在肌肉骨骼系统中的一些常见应用：缓解骨转移引起的疼痛、治疗骨样骨瘤、硬纤维瘤、小关节病和其他正在发展的适应证。
