Lewin J S, Connell C F, Duerk J L, Chung Y C, Clampitt M E, Spisak J, Gazelle G S, Haaga J R
Department of Radiology, University Hospitals of Cleveland and Case Western Reserve University, OH 44106, USA.
J Magn Reson Imaging. 1998 Jan-Feb;8(1):40-7. doi: 10.1002/jmri.1880080112.
This clinical trial was performed to evaluate the safety and feasibility of interactive MR-guided radiofrequency (RF) interstitial thermal ablation (ITA) performed entirely within the MR imager. RF-ITA was performed on 11 intra-abdominal metastatic tumors during 13 sessions. The RF electrode was placed under MR guidance on a .2-T system using rapid fast imaging with steady state precession (FISP) and true FISP images. A custom 17-gauge electrode was used and was modified in four sessions to allow circulation of iced saline for cooling during ablation. Tissue necrosis monitoring and electrode repositioning were based on rapid T2-weighted and short-inversion-time inversion recovery (STIR) sequences. Morbidity and toxicity were assessed by clinical and imaging criteria. The region of tissue destruction was visible in all 11 tumors treated, as confirmed on subsequent contrast-enhanced images. No significant morbidity was noted, and patient discomfort was minimal. In conclusion, interactive MR-guided RF-ITA is feasible on a clinical .2-T C-arm system with supplemental interventional accessories with only minor patient morbidity. The ability to completely ablate tumors with RF-ITA depends on tumor size and vascularity.
本临床试验旨在评估在磁共振成像仪内完全进行的交互式磁共振引导射频（RF）间质热消融（ITA）的安全性和可行性。在13个疗程中，对11个腹部转移性肿瘤进行了RF-ITA。使用快速稳态进动快速成像（FISP）和真FISP图像，在0.2-T系统的磁共振引导下放置射频电极。使用定制的17号电极，并在四个疗程中进行了修改，以便在消融过程中使冰盐水循环以进行冷却。基于快速T2加权和短反转时间反转恢复（STIR）序列进行组织坏死监测和电极重新定位。通过临床和影像学标准评估发病率和毒性。在所有11个接受治疗的肿瘤中，均可看到组织破坏区域，后续增强图像证实了这一点。未发现明显的发病率，患者不适也最小。总之，在配备补充介入附件的临床0.2-T C形臂系统上，交互式磁共振引导RF-ITA是可行的，患者发病率很小。用RF-ITA完全消融肿瘤的能力取决于肿瘤大小和血管分布。
