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前列腺癌冷冻消融术中磁共振引导下输尿管支架置入——病例系列

In-Bore MRI-Guided Ureteral Stent Placement During Prostate Cancer Cryoablation-A Case Series.

作者信息

Whalen Sydney, Woodrum David, Thompson Scott, Adamo Dan, Lomas Derek, Mynderse Lance

机构信息

University of Illinois College of Medicine, Chicago, IL 60612, USA.

Mayo Clinic Department of Radiology, Rochester, MN 55905, USA.

出版信息

Diagnostics (Basel). 2025 Jul 15;15(14):1781. doi: 10.3390/diagnostics15141781.

Abstract

: Ureteral stents are widely used in the specialty of urology to preserve renal function and provide ureteral patency in cases of urolithiasis, strictures, malignancy, and trauma. This paper presents a novel application of prophylactic ureteral stents deployed under MRI-guidance for ureteral protection in the setting of in-bore salvage cryoablation therapy for recurrent and metastatic prostate cancer. This is the first known case series of ureteral stent placement using near real-time MRI. : A retrospective chart review was performed for all patients who underwent MRI-guided ureteral stent placement prior to in-bore cryoablation therapy from 2021 to 2022. Each case was managed by an interdisciplinary team of urologists and interventional radiologists. Preoperative and postoperative data were collected for descriptive analysis. Physics safety testing was conducted on the cystoscope and viewing apparatus prior to its implementation for stent deployment. : A total of seven males, mean age 73.4 years (range 65-81), underwent successful prophylactic, cystoscopic MRI-guided ureteral stent placement prior to cryoablation therapy of their prostate cancer. No intraoperative complications occurred. A Grade 2 postoperative complication of pyelonephritis and gross hematuria following stent removal occurred in one case. The majority of patients were discharged the same day as their procedure. : This case series demonstrates the feasibility of in-bore cystoscopic aided MRI guidance for ureteral stent placement. Ureteral stents can be used to increase the safety margin of complex cryoablation treatments close to the ureter. Furthermore, by following the meticulous MRI safety protocols established by MRI facility safety design guidelines, MRI conditional tools can aid therapy in the burgeoning interventional MRI space.

摘要

输尿管支架在泌尿外科专业中被广泛应用,以保护肾功能,并在尿路结石、狭窄、恶性肿瘤和创伤等病例中保持输尿管通畅。本文介绍了一种新型应用,即在磁共振成像(MRI)引导下放置预防性输尿管支架,用于复发性和转移性前列腺癌的腔内挽救性冷冻消融治疗中的输尿管保护。这是已知的首例使用近实时MRI进行输尿管支架置入的病例系列。:对2021年至2022年在腔内冷冻消融治疗前接受MRI引导下输尿管支架置入的所有患者进行了回顾性病历审查。每个病例均由泌尿外科医生和介入放射科医生组成的跨学科团队管理。收集术前和术后数据进行描述性分析。在使用膀胱镜和观察设备进行支架置入之前,对其进行了物理安全测试。:共有7名男性,平均年龄73.4岁(范围65 - 81岁),在前列腺癌冷冻消融治疗前成功接受了预防性膀胱镜MRI引导下输尿管支架置入。术中无并发症发生。1例患者在支架取出后出现2级术后并发症肾盂肾炎和肉眼血尿。大多数患者在手术当天出院。:该病例系列证明了腔内膀胱镜辅助MRI引导下输尿管支架置入的可行性。输尿管支架可用于增加靠近输尿管的复杂冷冻消融治疗的安全 margins。此外,通过遵循MRI设施安全设计指南制定的细致MRI安全协议,MRI条件工具可在新兴的介入MRI领域辅助治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/daad/12294021/9e750f360b41/diagnostics-15-01781-g001.jpg

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