Jäger L, Müller-Lisse G U, Gutmann R, Feyh J, Thoma M, Reiser M
Institut für Radiologische Diagnostik, Klinikum Grosshadern der Ludwig-Maximilians-Universität München.
Radiologe. 1996 Mar;36(3):236-44. doi: 10.1007/s001170050067.
Laser-induced interstitial thermo-therapy (LITT) was introduced as a minimally invasive form of therapy for tumors in different anatomic regions. However, in the orofacial region, it has not been used so far for inoperable T4 carcinomas. Since vascular and neural structures are often close to the tumor or are even involved, online monitoring of LITT is necessary. The aim of our study was to establish a method of monitoring LITT with MRI (magnetic resonance imaging) in the orofacial region. Five patients with T4 carcinomas of the orofacial region underwent LITT under anesthesia. A 1.5 T whole-body imager with a circular polarized head coil was used. Before and after the intervention, the region of interest was studied using T1- and T2-weighted sequences in axial and coronal planes, with and without contrast enhancement (intravenous Gd-DTPA). Temperature distribution was monitored with a T1-weighted 2D-FLASH (fast low angle shot) sequence. The positioning of the optical fibers was monitored with MRI. Nd:YAG laser equipment was used for laser application. The necrosis was best seen on contrast-enhanced MRI. Immediately after LITT, the outcome could be determined by MRI. We proposed that MRI-guided LITT be used for neoplasms in the orofacial region at advanced stages.
激光诱导间质热疗（LITT）作为一种针对不同解剖区域肿瘤的微创治疗方法被引入。然而，在口面部区域，迄今为止它尚未用于无法手术的T4期癌。由于血管和神经结构常常靠近肿瘤甚至受累，因此LITT的在线监测是必要的。我们研究的目的是建立一种在口面部区域用MRI（磁共振成像）监测LITT的方法。五名头面部区域T4期癌患者在麻醉下接受了LITT。使用了一台配备圆极化头部线圈的1.5T全身成像仪。在干预前后，在有无对比增强（静脉注射钆喷酸葡胺）的情况下，使用T1加权和T2加权序列在轴向和冠状平面研究感兴趣区域。用T1加权二维快速低角度激发（2D-FLASH）序列监测温度分布。用MRI监测光纤的定位。使用钕钇铝石榴石（Nd:YAG）激光设备进行激光照射。坏死在对比增强MRI上显示最佳。LITT后立即通过MRI可以确定结果。我们建议将MRI引导的LITT用于口面部区域晚期肿瘤。
